Open AccessPB2075 DIFFERENT IRON FORMULATIONS MIGHT CHANGE METHYLATION PATTERNS AND BONE MARROW MACROPHAGES POLARIZATION IN LOW RISK MYELODYSPLASTIC SYNDROMES (LRMDS)
Author(s) -
Giordano G.,
Lucchesi A.,
magri M.,
niro G.,
gasperi M.
Publication year - 2019
Publication title -
hemasphere
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 11
ISSN - 2572-9241
DOI - 10.1097/01.hs9.0000566784.85244.85
Subject(s) - bone marrow , medicine , gastroenterology , dna methylation , myelodysplastic syndromes , erythropoietin , ferritin , anemia , immunology , chemistry , biochemistry , gene expression , gene
Background: Iron status influences dna methylation. External factors as liposomes may switc‐off bone marrow macrophages M1 polarization that is related to inflammatory status. These things are important in ineffective hemopoiesis in LRMDS. Aims: To see if sucromial iron and sodium ferrigluconate support in LRMDS shows different dna metilation patterns and macrophages polarization in bone marrow. Methods This study is a retrospective nonrandomized study. 45 patients with low risk refractory anemia receiving support with erythropoietin 40000 UI two times/week, b12 300 mg/day and folate 15 mg/day were divided in 3 group of 15 patients. Group A received i.v. sodium ferrigluconate 65 mg/day for 7 days/month, group B received sucrosomial iron tablets every other day, group C don’t received iron. No significant differences among median Hb level (9.5 g/dl), median age (65 yo), sex, karyotype, sEpo, ferritin, Tsat, IPSS, transfusion need, were in the three groups. Follow‐up period was 6 months. The bone marrow M1 proinflammatory macrophages (iNOS high /CD163 low /CD14 + ) and M2 antiinflammatory (iNOS low /CD163 high /CD14‐) were analyzed by cytofluorimetry and dna methylation with methylation‐specific PCR. Bone marrow aspiration, M1 and M2 count, dna methylation, Hb level, transfusion need, ferritin and tsat level, CRP were recorded bimonthly. Results: All results were recorded at time 0, 2, 4 and 6 months. M1% was 1, 0.8, 0.7, 1 in group A, 1.2, 0.9, 0.6, 0.4 in group B, 0.8, 0.8, 0.9, 1 in group C. M2% was0.4, 0.5, 0.3, 0.4 in group A, 0.4, 0.5, 0.5,0.6 in group B, 0.3, 0.3, 0.4,0.3 in group C. % of methilated cytosine was 6% in group A, 3% in group B, 5% in group C. CRP (ng/ml) was 6, 8, 10, 12 in group A, 7, 5, 3, 2 in group B, 8, 6, 5, 5 in group C. Hb concentration (g/dl) was 9, 9.8, 11.5, 11.8 in group A, 9, 10.2, 11.5, 12.5 in group B, 9.5, 10, 10.5, 10.9 in group C. Transfusion need (units) was 2 in group A, 2 in group B, 2 in group C. Summary/Conclusion: In LRMDS iron support improves erythropoietin effectiveness and reduces dna methylation. Sucrosomial iron reduces macrophages M1 polarization and CRP, improving effective hemopoiesis.