Iron Sequestration and Anemia of Inflammation

Abstract Abstract 2050 Anemia of inflammation (AI, anemia of chronic disease) is a common complication of a wide variety of inflammatory conditions including infections and connective tissue diseases. Because the iron regulatory protein hepcidin is increased during inflammation and overexpression of hepcidin recapitulates many of the features of AI, hepcidin is currently believed to be the primary mediator of AI. Furthermore, Sasu and colleagues showed that blocking hepcidin could improve AI (Blood, Vol. 115, No. 17, pp. 3616-24). To test whether hepcidin is indeed necessary for the development of AI, we used two models of AI in hepcidin knockout mice. The first model, using heat-killed Brucella abortus to model brucellosis, is the same as that used by Sasu and colleagues. The second model uses complete Freund's adjuvant to model Mycobacterial disease. We showed that absence of hepcidin did not protect against the development of anemia. Furthermore, we show that this was an iron restricted anemia arguing that iron sequestration can occur independent of hepcidin. This study indicates that hepcidin may not be the central mediator in all AI. Future research will be needed to determine why the anti-hepcidin treatment used by Sasu and colleagues was able to improve the anemia. Disclosures: Ganz: Intrinsic Life Sciences: Employment, Membership on an entity's Board of Directors or advisory committees.

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‘Anemia of Inflammation’ Explains Iron Issues in RA

Family Practice News ◽

10.1016/s0300-7073(07)71018-6 ◽

2007 ◽

Vol 37 (16) ◽

pp. 34

Author(s):

MIRIAM E. TUCKER

Keyword(s):

Anemia Of Inflammation

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POS0567 HEPCIDIN IS POTENTIAL BIOMARKER TO DISTINGUISH BETWEEN IRON DEFICIENCY ANEMIA AND ANEMIA OF INFLAMMATION IN RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3303 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 518.2-518

Author(s):

E. Galushko ◽

A. Semashko ◽

A. Gordeev ◽

A. Lila

Keyword(s):

Rheumatoid Arthritis ◽

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Complete Blood Count ◽

Deficiency Anemia ◽

Reactive Protein ◽

Potential Biomarker ◽

Serum Hepcidin ◽

Proper Diagnosis ◽

Anemia Of Inflammation

Background:Anemia of inflammation (AI) and iron deficiency anemia (IDA) are the two most prevalent forms of anemia in patients with rheumatoid arthritis (RA). Diagnosis becomes challenging if AI is associated with true ID (AI/ID), as there is still a lack of a gold standard for differentiation between AI and AI/ID. However, as therapies to overcome anemia differ, proper diagnosis and understanding of underlying pathophysiological regulations are necessary.Objectives:The aim of the study was to evaluate the clinical efficiency of hepcidin, a key regulator of iron metabolism, in the diagnosis of IDA, as well as the differential diagnosis of AI/ID and AI in patients with RA.Methods:The study was undertaken 96 patients with RA, 67 of them were diagnosed anemia according to WHO criteria (104,3±21,4 g/l). Anemic patients and anemia-free patients with RA (n=29) were comparable (p>0.05) in age (44.4±14.8 and 49.8±9.3 years), disease duration (73.5±65.4 and 59.8±48.3 months) and DAS28 (6.3±1.6 and 5.9±1.9). All cases were subjected to following tests: complete blood count with peripheral smear, serum C-reactive protein, serum interleukin-6, iron studies, serum soluble transferrin receptor (sTfR), and serum hepcidin. Patients with RA and anemia were divided two groups: 25 patients with IDA and 42 - with AI. The AI cases were subdivided into pure AI and AI with coexistent ID (n=15).Results:The mean serum hepcidin concentration was significantly increased in pure AI patients (123.85±25.8 ng/mL) as compared to those in IDA patients (63.9±22.8 ng/mL, P < 0.05) and anemia-free patients with RA (88.1±39.09 ng/mL). Also, compared to pure AI patients [normal sTfR levels (<3 µg/mL)], the serum hepcidin concentration was reduced significantly in AI patients with ID [high sTfR levels (≥3 µg/mL)] with a mean of 79.0±23.97 ng/mL.Conclusion:Hepcidin measurement can provide a useful tool for differentiating AI from IDA and also help to identify an iron deficiency in AI patients. This might aid in the appropriate selection of therapy for these patients.Disclosure of Interests:None declared

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Black pepper prevents anemia of inflammation by inhibiting hepcidin over-expression through BMP6-SMAD1/ IL6-STAT3 signaling pathway

Free Radical Biology and Medicine ◽

10.1016/j.freeradbiomed.2021.03.019 ◽

2021 ◽

Author(s):

Somesh Banerjee ◽

Parul Katiyar ◽

Lokesh Kumar ◽

Vijay Kumar ◽

Shashank Sagar Saini ◽

...

Keyword(s):

Signaling Pathway ◽

Black Pepper ◽

Over Expression ◽

Stat3 Signaling ◽

Stat3 Signaling Pathway ◽

Anemia Of Inflammation

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Surgical Treatment of Sialolithiasis Leads to Improvement in the Complete Blood Count

Biology ◽

10.3390/biology10050414 ◽

2021 ◽

Vol 10 (5) ◽

pp. 414

Author(s):

Gal Avishai ◽

Idan Rabinovich ◽

Hanna Gilat ◽

Gavriel Chaushu ◽

Liat Chaushu

Keyword(s):

Surgical Treatment ◽

Blood Cell ◽

Red Blood Cell ◽

Blood Count ◽

Complete Blood Count ◽

Blood Cell Count ◽

Blood Profile ◽

Post Procedure ◽

Red Blood Cell Count ◽

Anemia Of Inflammation

Sialolithiasis is a chronic disease in which a sialolith (salivary stone) causes recurrent inflammation of the affected salivary gland. Anemia of inflammation is a well-described pathology in which a chronic inflammatory disease leads to a reduction in the red blood cell count, hemoglobin and hematocrit values. In this retrospective cohort study, we aim to find whether removal of the sialolith and alleviation of the inflammation affect the complete blood count results. We examined data regarding forty-nine patients who underwent surgery for the removal of a submandibular gland sialolith using the duct-stretching technique. Complete blood counts two years before and after the surgical procedure were collected. The average pre-procedure and post-procedure values were calculated for each patient to establish the average blood profile. The pre- and post-procedure values were compared to evaluate the effect of the surgical treatment on the blood profile. We found that the average blood count values for patients with sialolithiasis were towards the lower end of the normal range. Post-surgery, a significant increase in hematocrit, hemoglobin and red blood cell count was observed, which was more pronounced in the older age group and in patients with co-morbidities. We conclude that sialolith removal surgery is associated with significant improvement in the complete blood count values, especially in the elderly and in patients and with co-morbidities. The speculated pathogenesis is relative anemia of inflammation.

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Anemia of Inflammation

Hematology ◽

10.1182/asheducation-2010.1.276 ◽

2010 ◽

Vol 2010 (1) ◽

pp. 276-280 ◽

Cited By ~ 74

Author(s):

Cindy N. Roy

Keyword(s):

Inflammatory Diseases ◽

Underlying Disease ◽

Comorbid Condition ◽

Regulatory Pathways ◽

Hepcidin Expression ◽

Disease States ◽

Poor Outcomes ◽

The Impact ◽

Inflammatory Insult ◽

Anemia Of Inflammation

Abstract Inflammation arising from various etiologies, including infection, autoimmune disorders, chronic diseases, and aging, can promote anemia. The anemia of inflammation (AI) is most often normocytic and normochromic and is usually mild. Characteristic changes in systemic iron handling, erythrocyte production, and erythrocyte life span all contribute to AI. The preferred treatment is directed at the underlying disease. However, when the inflammatory insult is intractable, or the cause has not been diagnosed, there are limited options for treatment of AI. Because anemia is a comorbid condition that is associated with poor outcomes in various chronic disease states, understanding its pathogenesis and developing new tools for its treatment should remain a priority. Hepcidin antimicrobial peptide has taken center stage in recent years as a potent modulator of iron availability. As the technology for quantitative hepcidin analysis improves, hepcidin's role in various disease states is also being revealed. Recent insights concerning the regulatory pathways that modify hepcidin expression have identified novel targets for drug development. As the field advances with such therapeutics, the analysis of the impact of normalized hemoglobin on disease outcomes will confirm whether anemia is a reversible independent contributor to the morbidity and mortality associated with inflammatory diseases.

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