Elevated non-transferrin bound iron in the lungs of patients with Pneumocystis carinii pneumonia

Objective: The aim of the present work was to determine the concentrations of iron and iron-binding proteins in the lungs of patients suffering from P neumocystis carinii (PCP), which is crucial for justifying the treatment wi th iron-chelating agents in this disease. Patients mid Methods: Bronchoalveolar lavage was performed in 10 HIV patien ts with PCP and five healthy controls. Total iron and iron-binding proteins (transferrin, ferritin and lactoferrin) were measured in acellular broncho alveolar lavage fluid (BALF) in both groups. Iron was determined by atomic absorption spectrometry; transferrin and lactoferrin were measured using sp ecific enzyme-linked immunosorbent assays (ELISA); and ferritin concentrati on was quantified by automated immunonephelometry, Results: Our findings in patients with PCP demonstrated a six- to seven-fol d increase of total iron levels and an eight-fold increase of ferritin in b ronchoalveolar lavage fluid when compared with controls. No significant dif ferences were found in transferrin or lactoferrin levels, Moreover, our res ults suggest that this iron is non-transferrin bound, Conclusion: Non-transferrin bound iron is increased in the lower respirator y tracts of PCP patients. This finding would lend experiment support to the use of iron-chelating agents in this disease.