Deparment of Medicine I, Medical University Innsbruck, Innsbruck, Austria.
Br J Haematol. 2010 Feb;148(3):449-55. doi: 10.1111/j.1365-2141.2009.07961.x. Epub 2009 Oct 15.
Recently, the iron and erythropoiesis-controlled growth differentiation factor 15 (GDF15) has been shown to inhibit the expression of hepcidin in beta-thalassaemia patients, thereby increasing iron absorption despite iron overload. To access the diagnostic and pathogenic impact of GDF15 in inflammatory anaemia the association of GDF15 expression with serum iron parameters and hepcidin was studied in patients suffering from iron deficiency anaemia (IDA), anaemia of chronic disease (ACD) and ACD subjects with true iron deficiency (ACD/IDA). GDF15 was significantly increased in both ACD and ACD/IDA, but not in IDA subjects as compared to controls. In contrast, hepcidin levels were significantly lower in IDA and ACD/IDA subjects than in ACD patients. IDA and ACD/IDA, but not ACD, showed an association between GDF15 and soluble transferrin receptor, an indicator of iron requirement for erythropoiesis. However, GDF15 did not correlate to hepcidin in either patient group. While GDF15 levels were linked to the needs for erythropoiesis and iron homeostasis in IDA, the immunity-driven increase of GDF15 may not primarily affect iron homeostasis and hepcidin expression. This indicates that other ACD-related factors may overcome the regulatory effects of GDF15 on hepcidin expression during inflammation.
最近，铁和红细胞生成素控制的生长分化因子 15（GDF15）已被证明可抑制β地中海贫血患者的铁调素表达，从而增加铁吸收，尽管存在铁过载。为了评估 GDF15 在炎症性贫血中的诊断和发病机制影响，研究了患有缺铁性贫血（IDA）、慢性病性贫血（ACD）和真正缺铁的 ACD 患者（ACD/IDA）的 GDF15 表达与血清铁参数和铁调素的相关性。与对照组相比，GDF15 在 ACD 和 ACD/IDA 患者中均显著升高，但在 IDA 患者中则不然。相反，IDA 和 ACD/IDA 患者的铁调素水平明显低于 ACD 患者。IDA 和 ACD/IDA，但不是 ACD，显示 GDF15 与可溶性转铁蛋白受体之间存在相关性，可溶性转铁蛋白受体是红细胞生成对铁需求的指标。然而，在任何一组患者中，GDF15 均与铁调素无相关性。虽然 GDF15 水平与 IDA 中红细胞生成和铁稳态的需求相关，但免疫驱动的 GDF15 增加可能不会主要影响铁稳态和铁调素表达。这表明在炎症期间，其他与 ACD 相关的因素可能会克服 GDF15 对铁调素表达的调节作用。
