Multiple Myeloma, Non-Hodgkin's Lymphoma And Castleman Cases Hepcidin MRNA Expression

Background:Anemia of chronic disease (ACD), also called anemia of inflammation (AOI) is the most common cause of anemia in clinic. A specific feature of ACD is iron disorder, which probably is caused by hepcidin, an iron-regulation hormone. Hepcidin can be elevated by interleukin6(IL-6) both in vivo and in vitro, the cytokine proved to elevate in multiple myeloma, non-Hodgkin’s lymphoma and Castleman disease. It’s unclear whether hepcidin is also elevated in these diseases.Purpose:1. The effect of multiple myeloma patients’serum on hepcidin expression of Hep-3b hepatoma cell line. If hepcidin expression is elevated, try to decrease it by adding IL-6antibody or recombinant human erythropoietin (rhEPO).2. Hepcidin expression in non-Hodgkin’s lymphoma patients and a Castleman disease patient.Methods:1. Sample collection:Collect the clinic information and serum of multiple myeloma and non-Hodgkin’s lymphoma. Collect the clinic information, serum, liver biopsy tissue and lymphnode mass tissue of a Castleman disease patient.2. Culture Hep-3b hepatoma cell line.3. Add multiple myeloma and non-Hodgkin’s lymphoma patients’serum the medium. Extract mRNA from Hep-3b cell and tissue, and detect hepcidin mRNA using RT-PCR.Results:1. The serum of untreated multiple myeloma patients elevated hepcidin expression of Hep-3b cell, compared to health control. This effect was neutralized by human IL-6antibody or rhEPO. 2. The serum of treated multiple myeloma patients did not elevate hepcidin expression of Hep-3b cell.3. The hemoglobin was stable during the follow up period of regularly treated multiple myeloma patients and the serum effect on Hep-3b cell hepcidin expression was reduced.4. The serum of non-Hodgkin’s lymphoma patients did not elevate hepcidin expression of Hep-3b cell.5. The Castleman disease patient’s Liver hepcidin expression was elevated, and there was hepcidin expression in the lymph node.Conclusion:Hepcidin could be increased by treated multiple myeloma patients’ serum and decreased by rhEPO, which indicates rhEPO is a potent treatment for ACD. IL-6/hepcidin pathway in Castleman disease patient’s liver and lymph node probably led to her severe anemia.