The Role of Hepcidin 25 in the Development of Anemic Syndrome Associated With Malignant Diseases

Abstract

Anemic syndrome (АС) is a frequent complication of cancer that gives poor results of treatment and reduces quality of live of patients. The literature review is devoted to the role of the peptide hormone hepcidin 25 (HP25), which regulates systemic and local iron homeostasis, in the development of anemia. The main biological function of HP25 is to reduce the level of iron in the bloodstream, which realizes a decrease of the mobilization of iron from the depot and a decrease of absorption of iron in the intestine. Modern approaches to the diagnosis and treatment of anemic disease in oncological practise necessarily include an assessment of the level of HP25. It was shown that HP25 is involved in the pathogenesis of anemia in malignant neoplasms. Oncological diseases are often accompanied by high levels of pro-inflammatory cytokines, in particular interleukin-6 (IL-6), which causes an increase in the production of HP25. Under the influence of IL-6, HP25 blocks ferroportins and iron release by macrophages, which leads to the development of functional iron deficiency and iron deficiency erythropoiesis, thus, with prolonged exposure to pro-inflammatory cytokines, anemia of chronic disease develops. The treatment of АС associated with malignant neoplasms is a complex procedure. Therapeutic effect on HP25 and IL-6 is a promising prospect for the correction of anemia in cancer patients. New strategies in the pathogenetic therapy of patients with anemia are associated with the use of antihepcidin drugs that reduce the level of HP25 in the blood. However, some studies have shown that an increase in the iron content in the bloodstream increases its accessibility to the tumor and promotes its growth; therefore, further, more in-depth study of the problem of correcting АС in cancer patients is necessary

Diagnostics and Treatment of Anemic Syndrome in Patients With Breast Cancer on the Background of Neoadjuvant Chemotherapy

“…При этом предпочтительны лекарственные формы для внутривенного введения, так как при приеме внутрь железо плохо всасывается. Более высокое содержание сывороточного ФР (100-800 нг / мл), снижение средней концентрации HGB в ретикулоците и появление в периферической крови гипохромных RBC более 5 % свидетельствуют о ФДЖ [4,7].…”

“…Важно дифференцировать ФДЖ и железодефицитную анемию (ЖДА), так как они имеют одинаковые морфологические характеристики, но их лечение принципиально различается. Терапевтическое воздействие на ГП25 и ИЛ-6 -многообещающая перспектива для коррекции анемии онкологических больных [3,4]. Необходимость идентификации вариантов АС для выбора адекватных методов терапии делает актуальной проблему дифференциальной диагностики анемии.…”