Serum Holoferritin Reliably Assesses Body Iron Stores, Unconfounded By Inflammation Or Other Health Variables. INACG Symposium, Marrakech, Morocco, 3-7 February 2003.

CV#847A. Herbert V. Serum Holoferritin Reliably Assesses Body Iron Stores, Unconfounded By Inflammation Or Other Health Variables. INACG Symposium, Marrakech, Morocco, 3-7 February 2003.

SERUM HOLOFERRITIN RELIABLY ASSESSES BODY IRON STORES, UNCONFOUNDED BY INFLAMMATION OR OTHER HEALTH VARIABLES.

V Herbert. Mount Sinai-NYU Health System & Bronx V.A. Medical Center, Bronx, NY, 10468 United States.

The various non-invasive tests for iron status recommended by WHO (Nutritional Anaemias. WHO Technical Report Series No. 405, 1968) and INACG all suffer from confounding variables. The invasive ìgold standardî against which all these tests are judged is the microscope examination for iron of an unstained and/or stained bone marrow aspirate. We propose serum holoferritin as a preferred (because non-invasive) ìgold standard.î This is because body iron is stored, both in circulating plasma and in storage reticuloendothelial (R.E.) cells, on the inner surface of the soccer-ball-shaped molecules of ferritin protein, and the number of iron atoms in circulating ferritin protein molecules is the same as in ferritin storage cells, with no confounding variables. Each ferritin molecule contains from 0 (severe iron deficiency) to 4,500 (severe iron overload) atoms of iron. Serum ferritin protein is an acute phase reactant (production chronically increased by any infection and/or other co-existent acute or chronic inflammatory process), so measuring the number of ferritin molecules per ml serum is unreliable as a measure of iron stores. Serum transferrin saturation is also unreliable, because transferrin protein is a reverse acute phase reactant, production chronically reduced by any inflammatory process. To solve this problem, our group created an assay for the number of atoms of iron per molecule of serum ferritin protein (ferritin-iron) (holoferritin). This reliably measures body iron stores, unconfounded by inflammation (Herbert et al. Stem Cells 1994; 12:289-303). Comparisons of serum holoferritin vs all 3 of the standard serum tests of iron status (serum iron, percent saturation of transferrin, ferritin) show that holoferritin gives the same body iron store status as does invasive ìgold standardî bone marrow aspirate or liver biopsy (Herbert et al. Stem Cells 1997; 15:291-6) whereas all other serum tests, alone or combined, are confounded by many variables.