Serum hepcidin following autologous hematopoietic cell transplantation: an illustration of the interplay of iron status, erythropoiesis and inflammation

Jaspers, Aurélie; Baron, Frédéric; Willems, Évelyne; Seidel, Laurence; Wiegerinck, Erwin T.; Swinkels, Dorine W.; Béguin, Yves

doi:10.3324/haematol.2013.100032

Cited by 8 publications

(12 citation statements)

References 14 publications

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“…Hepcidin expression is regulated by inflammation (upregulation), erythropoiesis, and hypoxia (downregulation) and hepcidin concentrations are correlated with iron homeostasis biomarkers (e.g., ferritin, transferrin), although the relative hierarchy and biological importance of each under normal and clinical circumstances remain to be established ( 26 , 37 – 39 ). By using statistical techniques designed to reduce redundancy of multiple correlated factors, further insight into the iron and infection relation is possible.…”

Section: Discussionmentioning

confidence: 99%

Elevated Hepcidin Is Part of a Complex Relation That Links Mortality with Iron Homeostasis and Anemia in Men and Women with HIV Infection

Minchella

Armitage

Darboe

et al. 2015

The Journal of Nutrition

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Background: Early and chronic inflammation is a hallmark of HIV infection, and inflammation is known to increase hepcidin expression. Consequently, hepcidin may be a key determinant of the iron homeostasis and anemia associated with poorer HIV prognoses. Objective: The objective of this study was to understand how hepcidin is related to anemia, iron homeostasis, and inflammation at HIV diagnosis and to investigate associations between hepcidin and all-cause mortality in HIV infection. Methods: In a retrospective cohort, baseline plasma hepcidin was measured by competitive enzyme immunoassay within 3 mo of HIV diagnosis in 196 antiretroviral-naive Gambians. Iron homeostasis [hemoglobin, plasma transferrin, ferritin, iron, soluble transferrin receptor (sTfR)] and inflammation [α1-antichymotrypsin (ACT)] from the same plasma sample were available, as were absolute CD4 cell counts, age, gender, body mass index (BMI), and HIV type. Results: Anemia was common across the spectrum of immunosuppression [CD4 cell counts (prevalence of anemia): >500 cells/μL (68%), 200–500 cells/μL (73%), and <200 cells/μL (89%); P = 0.032] and in men (81%) and women (76%). Increasing hepcidin was associated with iron homeostasis biomarkers (higher ferritin and lower transferrin, hemoglobin, and sTfR), inflammation (higher ACT), and key health indicators (lower CD4 or BMI, advancing age, and male gender; P < 0.001 except for hemoglobin, P = 0.021). Elevated hepcidin was associated with greater all-cause mortality in a dose-dependent manner [intermediate vs. lowest tertile: unadjusted HR (95% CI), 1.95 (1.22, 3.10); upper vs. lowest tertile: 3.02 (1.91, 4.78)]. Principal components analysis identified 2 patterns composed of hepcidin-ferritin-transferrin, with or without ACT, and iron-sTfR-hemoglobin that may distinguish inflammation and erythropoiesis iron functions. Conclusions: Elevated hepcidin is independently associated with greater mortality in men and women with HIV infection, and hepcidin is also part of a complex relation linking iron homeostasis, anemia, and HIV. Understanding the mechanisms and role of hepcidin modulation may further guide evidence-based interventions needed to counter detrimental iron homeostasis and anemia in HIV infection.

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Section: Discussionmentioning

confidence: 99%

Elevated Hepcidin Is Part of a Complex Relation That Links Mortality with Iron Homeostasis and Anemia in Men and Women with HIV Infection

Minchella

Armitage

Darboe

et al. 2015

The Journal of Nutrition

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“…Our analyses of routine athlete's samples supported this observation: Despite strong apparent haemolysis in some of the control samples, no false positive results were found. However, physiological stress such as inflammation has to be investigated as such reactions are known to influence the iron metabolism by moving iron to the Reticulo‐histiocytary system . To prevent this, measurement of a marker of inflammation (C‐Reactive Protein) could be easily added to the analysis with the same automated technology in order to rule out interfering effect of inflammation .…”

Section: Discussionmentioning

confidence: 99%

“…However, physiological stress such as inflammation has to be investigated as such reactions are known to influence the iron metabolism by moving iron to the Reticulo-histiocytary system. [10] To prevent this, measurement of a marker of inflammation (C-Reactive Protein) could be easily added to the analysis with the same automated technology in order to rule out interfering effect of inflammation. [4] As both variables are measured in the same matrix, a single plasma-EDTA would be sufficient to perform the test.…”

Section: Discussionmentioning

confidence: 99%

A fast automated screening method for the detection of blood transfusion in sports

Leuenberger

Ansermet

Pottgießer

et al. 2014

Drug Testing and Analysis

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Currently, there is no simple direct screening method for the misuse of blood transfusions in sports. In this study, we investigated whether the measurement of iron in EDTA-plasma can serve as biomarker for such purpose. Our results revealed an increase of the plasma iron level up to 25-fold 6 h after blood re-infusion. The variable remained elevated 10-fold one day after the procedure. A specificity of 100% and a sensitivity of 93% were obtained with a proposed threshold at 45 µg/dL of plasma iron. Therefore, our test could be used as a simple, cost effective biomarker for the screening for blood transfusion misuse in sports.

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“…Interestingly, Jaspers et al (Jaspers et al, 2017) reported that in patients (n=45, mean age 55±10 years) with autologous haematopoietic cell transplantation, serum hepcidin levels before and after the transplant were driven by iron stores and EPO rather than inflammation.…”

Section: Hepcidinmentioning

confidence: 99%

Iron status in the elderly: A review of recent evidence

Wawer

Jennings

Fairweather‐Tait

2018

Mechanisms of Ageing and Development

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A comprehensive literature review of iron status in the elderly was undertaken in order to update a previous review (Fairweather-Tait et al, 2014); 138 summarised papers describe research on the magnitude of the problem, aetiology and age-related physiological changes that may affect iron status, novel strategies for assessing iron status with concurrent health conditions, hepcidin, lifestyle factors, iron supplements, iron status and health outcomes (bone mineral density, frailty, inflammatory bowel disease, kidney failure, cancer, cardiovascular, and neurodegenerative diseases). Each section of this review concludes with key points from the relevant papers. The overall findings were that disturbed iron metabolism plays a major role in a large number of conditions associated with old age. Correction of iron deficiency/overload may improve disease prognosis, but diagnosis of iron deficiency requires appropriate cut-offs for biomarkers of iron status in elderly men and women to be agreed. Iron deficiency (with or without anemia), anemia of inflammation, and anemia of chronic disease are all widespread in the elderly and, once identified, should be investigated further as they are often indicative of underlying disease. Management options should be reviewed and updated, and novel therapies, which show potential for treating anemia of inflammation or chronic disease, should be considered.

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Serum hepcidin following autologous hematopoietic cell transplantation: an illustration of the interplay of iron status, erythropoiesis and inflammation

Cited by 8 publications

References 14 publications

Elevated Hepcidin Is Part of a Complex Relation That Links Mortality with Iron Homeostasis and Anemia in Men and Women with HIV Infection

Elevated Hepcidin Is Part of a Complex Relation That Links Mortality with Iron Homeostasis and Anemia in Men and Women with HIV Infection

A fast automated screening method for the detection of blood transfusion in sports

Iron status in the elderly: A review of recent evidence

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