Serum hepcidin level and rheumatoid arthritis disease activity

Sahebari, Maryam; Rezaieyazdi, Zahra; Hashemy, Seyed Isaac; Khorasani, Sahar; Shahgordi, Sanaz; Alizadeh, Mohammad Karim; Ghaeni, Abdolmomen; Khodashahi, Mandana

doi:10.5152/eurjrheum.2018.18114

Cited by 12 publications

(13 citation statements)

References 26 publications

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“…Functional iron deficiency in ACD can be due to overexpression of iron-regulatory hormone, hepcidin, leading to sequestration into storage sites from circulation, resulting in hypoferrinemia and iron-restricted erythropoiesis. Although decreased serum hepcidin levels were reported to correlate with the reduction of disease activity [52], this observation was not evident in other studies [53,54]. Hepcidin could be suppressed, independently of inflammation.…”

Section: Anemia Of Rheumatoid Arthritis (Ra)mentioning

confidence: 84%

Anemia of Inflammation with An Emphasis on Chronic Kidney Disease

Begum

Latunde-Dada

2019

Nutrients

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Iron is vital for a vast variety of cellular processes and its homeostasis is strictly controlled and regulated. Nevertheless, disorders of iron metabolism are diverse and can be caused by insufficiency, overload or iron mal-distribution in tissues. Iron deficiency (ID) progresses to iron-deficiency anemia (IDA) after iron stores are depleted. Inflammation is of diverse etiology in anemia of chronic disease (ACD). It results in serum hypoferremia and tissue hyperferritinemia, which are caused by elevated serum hepcidin levels, and this underlies the onset of functional iron-deficiency anemia. Inflammation is also inhibitory to erythropoietin function and may directly increase hepcidin level, which influences iron metabolism. Consequently, immune responses orchestrate iron metabolism, aggravate iron sequestration and, ultimately, impair the processes of erythropoiesis. Hence, functional iron-deficiency anemia is a risk factor for several ailments, disorders and diseases. Therefore, therapeutic strategies depend on the symptoms, severity, comorbidities and the associated risk factors of anemia. Oral iron supplements can be employed to treat ID and mild anemia particularly, when gastrointestinal intolerance is minimal. Intravenous (IV) iron is the option in moderate and severe anemic conditions, for patients with compromised intestinal integrity, or when oral iron is refractory. Erythropoietin (EPO) is used to treat functional iron deficiency, and blood transfusion is restricted to refractory patients or in life-threatening emergency situations. Despite these interventions, many patients remain anemic and do not respond to conventional treatment approaches. However, various novel therapies are being developed to treat persistent anemia in patients.

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Section: Anemia Of Rheumatoid Arthritis (Ra)mentioning

confidence: 84%

Anemia of Inflammation with An Emphasis on Chronic Kidney Disease

Begum

Latunde-Dada

2019

Nutrients

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“…In one study, patients with RA and iron deficiency had significantly decreased serum hepcidin levels compared to those with RA and anemia with chronic inflammation 17 . As hepcidin is influenced by inflammation and iron metabolism, results differ on the influence on Hb and disease activity associated with hepcidin on RA 16,18 . Furthermore, in the same study of patients with RA, iron metabolism was related to serum hepcidin levels cross-sectionally, but inflammation was related longitudinally 19 .…”

Section: Discussionmentioning

confidence: 99%

Serum hepcidin level, iron metabolism and osteoporosis in patients with rheumatoid arthritis

Sato

Takai

Kazama

et al. 2020

Sci Rep

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Hepcidin, a major regulator of iron metabolism and homeostasis, is regulated by inflammation. Recent studies have suggested that hepcidin and iron metabolism are involved in osteoporosis, and the aim of this study was to determine whether serum hepcidin levels are correlated with the degree of osteoporosis in patients with rheumatoid arthritis (RA). A total of 262 patients with RA (67.5 ± 11.4 years; 77.5% female) were enrolled. Serum iron, ferritin, and hepcidin levels were positively correlated each other. Multiple regression analyses revealed that the serum iron level was positively correlated with femoral T and Z scores, whereas the serum hepcidin level was not. Serum hepcidin level was correlated with the serum 25-hydroxy vitamin D level, which was in turn positively related to the femoral Z score. Serum hepcidin and serum iron were indirectly and directly related to osteoporosis in patients with RA.

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“…12,24 Hepcidin median was highest in active RA and lowest in control subjects, with significantly different intermediate levels in inactive RA patients. In a study by Sahebari et al (2018), the authors found no relation between hepcidin levels and RA activity; they categorized RA activity using the 5.1 DAS28 cutoff limit. 25 Another study reported a significant increase of serum hepcidin with the active status (DAS28>3.2 was used to define disease activity).…”

Section: Discussionmentioning

confidence: 99%

“…In a study by Sahebari et al (2018), the authors found no relation between hepcidin levels and RA activity; they categorized RA activity using the 5.1 DAS28 cutoff limit. 25 Another study reported a significant increase of serum hepcidin with the active status (DAS28>3.2 was used to define disease activity). 12 The results of the latter study are similar to our results.…”

Section: Discussionmentioning

confidence: 99%

Erythroferrone Expression in Anemic Rheumatoid Arthritis Patients: Is It Disordered Iron Trafficking or Disease Activity?

Youssef

Hassan²,

Morad

et al. 2021

JIR

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Purpose: Erythroferrone (ERFE) is well acknowledged for its inhibitory function on hepcidin synthesis in the liver during stress erythropoiesis, thereby ensuring sufficient iron supply to bone marrow erythroblasts. Hepcidin plays an indispensable role in the pathogenesis of anemia of chronic disease (ACD). Thus, ERFE was suggested to protect against ACD in various diseases. Rheumatoid arthritis (RA) is commonly involved with ACD and high hepcidin levels, with a further increase of the latter in active states. The present study is a case-control study that aimed to determine the pattern of ERFE expression in RA patients with concomitant ACD and study its relationship with hepcidin, erythropoietin (EPO) and disease activity. Patients and Methods: Fifty-five RA patients with ACD were categorized into active and inactive RA using the disease activity score (DAS28); 15 healthy subjects were included as control subjects. ERFE was measured for patients and control subjects using quantitative real-time polymerase chain reaction, in addition to testing for CBC, ESR, CRP, iron profile parameters and hepcidin. EPO was assessed for patients of both active and inactive RA groups. Results: ERFE and hepcidin showed the highest levels in active RA; ERFE values were similar in control subjects and inactive RA patients, while hepcidin was significantly higher in inactive RA than control subjects. Patients with high ERFE levels had higher RBC, Hct, MCV, hepcidin and EPO levels. Stepwise regression analysis has identified DAS28 and disease duration as the best predictors of ERFE values, whereas ERFE and hepcidin were independent predictors of disease activity. Conclusion:We introduce ERFE as a novel marker of RA activity. Although the inhibitory effect of ERFE on hepcidin is not evident, our results still indicate that ERFE may have a beneficial erythropoietic effect in the context of ACD in RA disease activity.

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Serum hepcidin level and rheumatoid arthritis disease activity

Cited by 12 publications

References 26 publications

Anemia of Inflammation with An Emphasis on Chronic Kidney Disease

Anemia of Inflammation with An Emphasis on Chronic Kidney Disease

Serum hepcidin level, iron metabolism and osteoporosis in patients with rheumatoid arthritis

Erythroferrone Expression in Anemic Rheumatoid Arthritis Patients: Is It Disordered Iron Trafficking or Disease Activity?

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