The Study Of Hepcidin Expression In Anemia Of Chronic Disease

Objectives:Anemia(defined as hemoglobin below recommended thresholds)is one of the most common and intractable nutritional problems in the world today.Multiple factors increase the risk of anemia such as genuinely or relatively iron deficiency,chronic diseases,micronutrient(folate,vitamin B12)deficiencies and genetically inherited traits such as thalassaemia,hemopoesic disorders such as aplastic anemia(AA),racial/ethnic disparities,among which iron deficiency and chronic disease are the two main causes of anemia.In recent years,with the discovery of Hepcidin,and later in the iron to its steady state,the research progress of the role played by the activity of hematopoietic,makes the study of iron metabolism and hematopoietic system correlation disease has achieved a new breakthrough.Hepcidin,a peptide hormone secreted mainly by the liver,in response to iron loading,inflammation and erythropoietic activities.The major action of hepcidin is to internalize and degrade the iron effluxtransporter ferroportin 1,which expressed on all iron-exporting cells.Meanwhile,the hepcidin-induced disturbance of iron named functional iron deficiency(FID)seems to be a major problem in ARC,including anemia companied acute leukemia(AL).Expression of hepcidin is regulated by iron,anemia,inflammation and the erythropoietic activities.The pathway regulating hepcidin in response to iron also modulates the pathway regulating hepcidin in response to inflammation.There was a cross-talk way which regulates hepcidin expression by iron and inflammation indicators.Recent studies proposed that GDF-15 could also regulate hepcidin expression.Hepcidin could also inhibit the progress of erythropoietic activies and vice versa.The mechanism of Hepcidin expression and regulation in ACD and CRA is yet to be clarified.This study aims to through the analysis of Hepcidin in the ACD,ACD/IDA,simple IDA,AcI and the expression level of cancer-related anemia,explore Hepcidin in change and the factors affecting the expression of these diseases.In order to provide new ideas for clinical treatment and prognosis evaluation of anemic diseases.Methods:We studied 64 cases of anemia,of which 23 were ACD(including 7 ACD/IDA),16 cases of pure IDA,25 cases of AcI,and 25 cases of normal control of age matching.The concentration of ferritin,hepcidin,as well as erythropoietic indicators(red blood cells(RBC),hemoglobin(Hb),reticulocytes(Ret),erythropoietin(Epo),GDF-15,and inflammation indicators(IL-6,hsCRP)were assessed.A normal control of 131 patients with gastrointestinal cancer and 40 patients with age were matched.And the indications of iron protein,Hepcidin,GDF-15 and hematopoiesis were detected in CRA patients,and the factors affecting Hepcidin expression were discussed.Results:Among people with chronic anemia,hepcidin levels from high to low are ACD,AcI> ACD/IDA> normal control group > IDA.In AcI group,Hepcidin level was higher than ACD/IDA,IDA and normal control group,and the difference was statistically significant.IDA group Hepcidin was lower than other groups.Ferritin significantly increased in ACD and AcI groups compared with normal controls,and decreased significantly in ACD/IDA and IDA groups.In patients with tumor correlation anemia,Hepcidin levels were significantly lower in patients with moderate and severe anemia than in the other two groups and the normal control group.The level of GDF-15 was significantly higher among the three groups of cancer patients than in the normal control group and among those with severe anemia.Conclusions:Hepcidin expression is affected by inflammatory cytokines and body storage iron,and it is affected by hematopoietic activity,and its horizontal determination is of great significance for the identification of ACD,ACD/IDA and IDA.In CRA,GDF-15 levels will rise along with the increase of anemia,and GDF-15 higher levels can inhibit the expression of Hepcidin,Hepcidin reduction can increase the absorption of iron,iron load of eventually lead to cancer patients.