Hepcidin and cytokines in anaemia.
Hepcidin and cytokines in anaemia.
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DOI：
10.1080/10245330400018540
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发表时间：
2004-10-01
期刊：
影响因子：
--
通讯作者：
Means, Robert T
中科院分区：
文献类型：
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作者：
Means, Robert T
铁调素是一种精氨酸诱导的抗菌蛋白，其在肝脏中产生，在血液中循环，并在尿液中排泄。它是肠粘膜铁平衡的主要调节剂，似乎在血色病和相关疾病的发病机制中起重要作用。铁调素似乎是与炎症相关的低铁血症的主要贡献者。血清铁蛋白浓度与尿或血清中的铁调素蛋白水平密切相关，某些肝腺瘤患者表现出小细胞性、低铁性铁调素依赖性贫血。由于这些原因，已经提出铁调素是慢性病贫血（ACD）发病机制中的主要因素，ACD是临床实践中常见的精氨酸介导的贫血，其特征在于具有足够网状内皮铁储存的低铁血症。然而，ACD的发病基础并不完全是由于铁代谢的变化，但也涉及红细胞存活和红细胞生成对贫血的反应异常。在这篇综述中，铁调素作为ACD的主要介质参与的证据进行评估。铁调素似乎是ACD中出现的全身性铁异常的一个主要因素;它是否有助于该综合征发病机制的其他方面，需要进一步研究。
Hepcidin is a cytokine-induced antibacterial protein which is produced in the liver, circulates in the blood, and is excreted in the urine. It is a major regulator of iron balance in the intestinal mucosa, and appears to have a significant role in the pathogenesis of haemochromatosis and related disorders. Hepcidin appears to be a major contributor to the hypoferraemia associated with inflammation. Serum ferritin concentration is strongly correlated with hepcidin protein levels in either urine or serum, and certain patients with hepatic adenomas exhibit a microcytic, hypoferraemic hepcidin-dependent anaemia. For these reasons, it has been proposed that hepcidin is a primary factor in the pathogenesis of the anaemia of chronic disease (ACD), a cytokine-mediated anaemia commonly encountered in clinical practice and characterized by hypoferraemia with adequate reticuloendothelial iron stores. However, the pathogenetic basis of ACD is not entirely due to changes in iron metabolism, but also involves abnormalities in red cell survival and the erythropoietic response to anaemia. In this review, the evidence for involvement of hepcidin as a major mediator of ACD is evaluated. Hepcidin appears to be a major factor in the systemic iron abnormalities seen in ACD; whether it contributes to the other aspects of the pathogenesis of the syndrome requires further investigation.