Serum Pro-hepcidin Could Reflect Disease Activity in Patients with Rheumatoid Arthritis

Abstract

The aim of this study was to analyze the relationship between serum pro-hepcidin concentration and the anemia profiles of rheumatoid arthritis (RA) and to estimate the pro-hepcidin could reflect the disease activity of RA. RA disease activities were measured using Disease Activity Score 28 (DAS28), tender/swollen joint counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Anemia profiles such as hemoglobin, iron, total iron binding capacity (TIBC), ferritin, and transferrin levels were measured. Serum concentration of pro-hepcidin, the prohormone of hepcidin, was measured using enzyme-linked immunosorbent assay (ELISA). Mean concentration of serum pro-hepcidin was 237.6±67.9 ng/mL in 40 RA patients. The pro-hepcidin concentration was correlated with rheumatoid factor, CRP, ESR, and DAS28. There was a significant correlation between pro-hepcidin with tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6. The pro-hepcidin concentration was significantly higher in the patients with active RA (DAS28>5.1) than those with inactive to moderate RA (DAS28≤5.1). However, the pro-hepcidin concentration did not correlate with the anemia profiles except hemoglobin level. There was no difference of pro-hepcidin concentration between the patients with anemia of chronic disease and those without. In conclusion, serum concentration of pro-hepcidin reflects the disease activity, regardless of the anemia states in RA patients, thus it may be another potential marker for disease activity of RA.

Interleukin‐1 receptor antagonist gene polymorphism and hepcidin in rheumatoid arthritis: Correlations with clinical and laboratory indices of disease activity

“…According to our results, hepcidin level was significantly increased in group II as compared to group I, moreover, its level were significantly correlated with RA disease activity score parameters. These findings agreed with previously reported studies (4,24). Indicating that hepcidin is a useful biomarker for detection of active inflammation and it reflects disease activity of RA patients.…”

Pathobiochemical Mechanisms Relating Iron Homeostasis with Parameters of Inflammatory Activity and Autoimmune Disorders in Rheumatoid Arthritis

“…29,30 The available information in the scientifi c literature on the informative value of prohepcidin for evaluation of the iron status is rather confusing. [31][32][33] According to Kim et al 31 serum prohepcidin correlates with the activity of the major disease process but not with the anemia condition. On the other hand, in another study 33 , the iron defi ciency in RA patients is related with the serum concentration of prohepcidin.…”

Role of hepcidin in the development of anemia in patients with rheumatoid arthritis

“…В 2010 г. было опубликовано исследование [16], в кото-ром авторы выявили существенные различия в уровнях гепсидина у больных с активным и неактивным РА. К сожалению, в нашей выборке не было пациентов с низкой активностью РА, что не позволило нам провес-ти подобный анализ.…”

“…При анализе общей группы больных с анемией не было выявлено достоверных различий в уровне гепсидина по сравнению с таковыми без анемии, что могло поставить под сомнение теоретические предпосылки развития АХЗ у больных РА, как было сделано в одном из исследований [16]. Нетипичным для АХЗ являлось и то, что уровень Hb положительно коррелировал с концентрацией гепсидина в сыворотке крови, т. е. наибольшие значения гепсидина выявлялись у пациентов с легкой степенью анемии, и поч-ти в 2 раза ниже они были у больных с уровнем гемоглоби-на <100 г/л.…”