Spss 16.0 free12/24/2022 ![]() This study was reported based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Īdvantaging the great number of patients at the multidisciplinary referral clinics of ALS at the Imam Khomeini Hospital Complex (Tehran, Iran) and applying a standard protocol, this study was conducted to reinvestigate the alterations of ferritin levels in the serum and CSF of ALS patients compared to the controls in response to the present controversies. On the other hand, applying certain protocols were suggested to eliminate the biases, among which the low number of ALS cases in most studies is a major problem. Thus, besides the controversies among the studies that assessed serum ferritin level, there is little knowledge concerning CSF ferritin in ALS. Although several studies have suggested that serum ferritin might be able to predict the prognoses of ALS, to date, there are a few studies that investigated the effect of ferritin levels in the cerebrospinal fluid (CSF) on the progression of ALS. ![]() On the contrary, some works investigating the iron and ferritin levels indicated decreased serum iron and non-significant alterations in the ferritin levels. However, whether the higher level of serum ferritin is specific to ALS is yet ambiguous. Studies have evaluated serum ferritin levels as an indicator of iron metabolism and suggested an increase in ALS patients compared to controls, , ]. The oxidative stress caused by a disturbance in iron distribution and the caused labile iron pool is suggested as one underlying mechanism causing neurodegeneration. This was primarily brought up based on the observation of antioxidant enzyme superoxide dismutase 1 (SOD-1) mutations in familial ALS. This mechanism is justifiable by the role of oxidative stress mechanisms in the pathogenesis of motor neuron damage in ALS. Moreover, some former studies showed alteration of iron and ferritin levels in serum and CSF in patients with ALS, , ]. Dysregulation of iron metabolism among ALS patients was investigated in previous studies, , ]. Former works have suggested iron homeostasis-related disorder in ALS that prompted many works to investigate the potential utilities of this mechanism. Previous studies suggested oxidative injury, excitotoxic stimulation, aggregation and/or dysfunction of critical proteins, and genetic factors as potential mechanisms of neurodegeneration. To the best of our knowledge, the exact mechanism of degeneration of neurons in ALS is not fully defined. One of the latest estimates regarding the geographical distribution of ALS has indicated an incidence of 0.89 per 100,000 py in East Asia and 0.79 per 100,000 in South Asia. With the latest prevalence rate of 5.2 per 100,000 cases in the US, the disease remains a challenge both diagnostically and prognostically. Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by upper and lower motor neuron involvement that could coincide.
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