Inappropriate expression of hepcidin is associated with iron refractory anemia: implications for the anemia of chronic disease
Inappropriate expression of hepcidin is associated with iron refractory anemia: implications for the anemia of chronic disease
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DOI：
10.1182/blood-2002-04-1260
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发表时间：
2002-11-15
期刊：
影响因子：
20.3
通讯作者：
Andrews, NC
中科院分区：
文献类型：
--
作者：
Weinstein, DA;Roy, CN;Andrews, NC
慢性病贫血是一种普遍存在的、知之甚少的疾病，其折磨患有多种疾病的患者，包括感染、恶性肿瘤和风湿性疾病。其特征在于红细胞前体的促红细胞生成素反应迟钝，红细胞存活减少，以及铁吸收和巨噬细胞铁保留缺陷，其中断铁向红细胞前体细胞的递送。我们注意到大的肝腺瘤患者有严重的铁难治性贫血，类似于慢性病贫血。这种贫血在腺瘤切除术或肝移植后自行消退。我们研究了腺瘤在贫血发病机制中的作用，发现它们产生不适当的高水平铁调素mRNA。铁调素是一种肽类激素，参与控制细胞释放铁。我们的结论是，铁调素起着重要的，在我们的亚组中观察到的肝腺瘤患者的贫血的致病作用，我们推测，这是重要的慢性疾病的贫血的发病机制。
The anemia of chronic disease is a prevalent, poorly understood condition that afflicts patients with a wide variety of diseases, including infections, malignancies, and rheumatologic disorders. It is characterized by a blunted erythropoietin response by erythroid precursors, decreased red blood cell survival, and a defect in iron absorption and macrophage iron retention, which interrupts iron delivery to erythroid precursor cells. We noted that patients with large hepatic adenomas had severe iron refractory anemia similar to that observed in anemia of chronic disease. This anemia resolved spontaneously after adenoma resection or liver transplantation. We investigated the role of the adenomas in the pathogenesis of the anemia and found that they produce inappropriately high levels of hepcidin mRNA. Hepcidin is a peptide hormone that has been implicated in controlling the release of iron from cells. We conclude that hepcidin plays a major, causative role in the anemia observed in our subgroup of patients with hepatic adenomas, and we speculate that it is important in the pathogenesis of the anemia of chronic disease in general.