Anemia of Chronic Disease
Anemia of Chronic Disease
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DOI：
10.1007/978-1-4939-7360-6_4
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
A. Besarab;S. Hemmerich
中科院分区：
文献类型：
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作者：
A. Besarab;S. Hemmerich
贫血是慢性疾病状态中观察到的常见病症，并且在这些慢性病患者中对其生活质量和生存具有负面影响。各种细胞因子和急性时相蛋白在慢性疾病贫血（ACD）的发病机制中起重要作用，并且通过铁调素和铁蛋白分子的铁代谢的改变在很大程度上导致随后的贫血。由于它是一种非特异性贫血，因此通常很难正确诊断。为了诊断这种疾病，医生必须将潜在疾病的可能临床途径与改变的铁代谢和对促红细胞生成素（EPO）的反应的变化相关联。重要的是要排除伴随的缺铁和其他原因的贫血，因为在大多数情况下，不这样做将导致标准治疗失败。治疗方案包括使用红细胞生成刺激剂、输血和补铁，以及治疗基础疾病。本文将回顾ACD的发病机制，提出目前的治疗方案，并建议未来的治疗干预目标，如螯合剂，铁调素拮抗剂，和其他影响红细胞生成的药物。
Anemia is a common condition observed in chronic disease states and in these chronically ill patients has a negative impact on their quality of life and survival. Various cytokines and acute phase proteins play important roles in the pathogenesis of the anemia of chronic disease (ACD) and alterations in the metabolism of iron via the molecules, hepcidin, and ferritin are largely responsible for the consequent anemia. Because it is a non-specific anemia, it is often difficult to diagnose properly. To diagnose this disorder, the physician must correlate the possible clinical pathways of the underlying disease with changes in altered iron metabolism and response to erythropoietin (EPO). It is important to rule out concomitant iron deficiency and other causes of anemia since failure to do so will in most cases lead to failure of standard therapy. Treatment options involve the use of erythropoiesis-stimulating agents, blood transfusion, and iron supplementation, in addition to treating the underlying disease. This discourse will review the pathogenesis of ACD, suggest current therapeutic options, and suggest future targets for therapeutic intervention such as chelating agents, hepcidin antagonists, and other agents affecting erythropoiesis.