Soluble transferrin receptor and zinc protoporphyrin – competitors or efficient partners?

Metzgeroth, Georgia; Adelberger, Verena; Dorn-Beineke, Alexandra; Kühn, Christian; Schätz, Michael; Maywald, Ole; Bertsch, Thomas; Wisser, H.; Hehlmann, Rüdiger; Hastka, Jan

doi:10.1111/j.1600-0609.2005.00515.x

Cited by 39 publications

(27 citation statements)

References 37 publications

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“…Each have their own disadvantages. 1,68,69 In contrast to increased levels of hepcidin in ACD, both in vitro iron deficiency 11 and classic IDA in humans are associated with low hepcidin levels 13,41 which makes hepcidin a potential marker for detection of IDA in ACD.…”

Section: Differential Diagnosis and Therapeutic Implicationsmentioning

confidence: 99%

Hepcidin: from discovery to differential diagnosis

Kemna¹,

Tjalsma²,

Willems³

et al. 2008

Haematologica

268

186

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Although iron is essential for living organisms to survive, its reactive properties require strict regulation in order to prevent toxic effects. Hepcidin, a liver produced peptide hormone, is thought to be the central regulator of body iron metabolism. Its production is mainly controlled by the erythropoietic activity of the bone-marrow, the amount of circulating and stored body iron, and inflammation. Recent reports, however, provide new hypotheses on how hepcidin might exert its regulatory function. Although hepcidin was first discovered in human urine and serum, most of our understanding of hepcidin regulation and action comes from in vitro and mice studies that often use hepcidin mRNA expression as a read out. The difficulties in carrying out studies in humans have mostly been due to the lack of suitable hepcidin assay. The recent development of assays to measure hepcidin in serum and urine has offered new opportunities to study hepcidin regulation in humans. However, for the moment, only a small number of laboratories are able to perform these assays. The aim of this review is to discuss insights into hepcidin regulation obtained from recent clinical studies in the light of findings from in vitro and mice studies. Ongoing studies in humans should provide us with more information on the etiology of iron metabolism disorders in order to create new therapeutic strategies and improve differential diagnosis protocols for these diseases.

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Section: Differential Diagnosis and Therapeutic Implicationsmentioning

confidence: 99%

Hepcidin: from discovery to differential diagnosis

Kemna¹,

Tjalsma²,

Willems³

et al. 2008

Haematologica

268

186

View full text Add to dashboard Cite

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“…As a large proportion of sTfR is derived from eythroid precursors in the bone marrow, changes in the rate of erythropoiesis also affect sTfR concentrations. In Fe-replete individuals sTfR is an accurate indicator of erythropoiesis (113) , whereas in those individuals with a steady rate of erythropoiesis sTfR is an accurate indicator of tissue Fe depletion (114) . Unfortunately, pregnancy is associated with marked changes in both erythropoiesis and body Fe stores that introduce considerable uncertainty as to the primary cause of changes in sTfR concentrations.…”

Section: Serum Soluble Transferrin Receptormentioning

confidence: 99%

Assessment and interpretation of micronutrient status during pregnancy

Wheeler

2008

Proc. Nutr. Soc.

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Accurate assessment of maternal micronutrient status is critical to the prevention of suboptimal micronutrient status and anaemia during pregnancy. Measurement of Fe, folate and vitamin B12status is complicated by adaptive changes to maternal and placental physiology that markedly affect concentrations of circulating micronutrients and their functional biomarkers. Validation of new assessment methods by comparison with gold standards is often prevented by ethical considerations. Antenatal screening in the UK is predominantly concerned with the detection of anaemia, although estimation of maternal Fe stores by serum ferritin at the start of antenatal care may be a more effective preventive strategy. Functional assessment of maternal anaemia is highly problematic, so instead reference data are used for its definition. The effect of mild-to-moderate anaemia on pregnancy outcome is unclear because of the crude nature of its assessment and the influence of confounding factors. Fe-deficient erythropoiesis may be detected by assessment of erythrocyte Zn protoporphyrin and reticulocyte Hb, although such measures may be unavailable in many clinical laboratories. Serum soluble transferrin receptor is highly responsive to tissue Fe deficiency and is less affected by inflammation than most other indicators. Direct inter-assay comparison of serum and erythrocyte folate values is inadvisable since recovery rates differ greatly between methods. Serum total homocysteine is a useful functional biomarker of both folate and vitamin B12status but during pregnancy is influenced by other factors that reduce its sensitivity. Isotope-dilution liquid chromatography–tandem MS and serum holo-transcobalamin provide new opportunities to gain detailed data of folate species and vitamin B12fractions in large samples.

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“…In addition, maternal hypertension during pregnancy was associated with lower ZnPP/H levels at 4 months of age. Natural course of ZnPP/H As ZnPP/H is an indicator of iron available for erythropoiesis, 12,13 one would expect an increase in ZnPP/H levels after birth representing higher iron needs due to rapid growth and iatrogenic iron losses due to frequent blood sampling. However, we found a decrease in ZnPP/H levels in the first 6 weeks that returned to baseline levels thereafter.…”

Section: Discussionmentioning

confidence: 99%

“…Without sufficient amounts of iron available, zinc will be incorporated in protoporphyrin IX in red blood cells, causing an increase in ZnPP/H levels. [11][12][13] As moderately preterm infants are at risk to develop ID and IDA in the first 4 months of life, one might expect increasing ZnPP/H levels after birth. However, the natural course of ZnPP/H in the first months of life and the association of ZnPP/H with the development of ID and IDA is not known in these infants.…”

Section: Introductionmentioning

confidence: 99%

Zinc protoporphyrin/heme ratio as parameter of iron status in moderately preterm infants: natural course and associations in the first 4 months

et al. 2017

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OBJECTIVE:To determine the natural course of zinc protoporphyrin/heme ratio (ZnPP/H) and its role in the detection of iron deficiency (ID) and iron-deficiency anemia (IDA) in the first 4 months of life in moderately preterm infants. STUDY DESIGN: ZnPP/H was measured at 1 week, 6 weeks and 4 months postnatal age in a prospective cohort of 161 Dutch infants born at a gestational age of 32+0 to 36+6 weeks who did not receive an erythrocyte transfusion or iron supplementation. RESULTS: ZnPP/H levels decreased in the first 6 weeks and increased thereafter. CONCLUSION:In moderately preterm infants, ZnPP/H can be of additional value to detect infants at risk for IDA due to iron-deficient erythropoiesis at 4 months of age.

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Soluble transferrin receptor and zinc protoporphyrin – competitors or efficient partners?

Cited by 39 publications

References 37 publications

Hepcidin: from discovery to differential diagnosis

Hepcidin: from discovery to differential diagnosis

Assessment and interpretation of micronutrient status during pregnancy

Zinc protoporphyrin/heme ratio as parameter of iron status in moderately preterm infants: natural course and associations in the first 4 months

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