Kato Akihiko
Division of Blood Purification, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Shizuoka, Japan.
Future Cardiol. 2010 Nov;6(6):769-71. doi: 10.2217/fca.10.97.
Hepcidin is a key regulator controlling iron intestinal absorption and distribution through the body. The article by van der Putten et al. examined the association between hepcidin-25 and erythropoietin responsiveness and inflammation in erythropoietin-naive, iron-replete patients with chronic heart failure and chronic kidney disease. A cross-sectional observation revealed that serum hepcidin-25 was elevated almost twofold when compared with levels in healthy subjects. Hepcidin-25 was inversely correlated with hemoglobin (r(2) = 0.18; p < 0.02), and positively with ferritin (r(2) = 0.51; p < 0.01) and transferrin saturation (r(2) = 0.14; p < 0.03), while it did not correlate with levels of IL-6 and highly sensitive C-reactive protein. They found that 2-week erythropoietin therapy (50 IU/kg/week) significantly decreased hepcidin-25 levels. The magnitude of the decrease in hepcidin-25 levels correlated with the increase in reticulocytes (r(2) = 0.23; p < 0.03) and soluble transferrin receptor (r(2) = 0.23; p = 0.03), but not with inflammatory markers. A decline in hepcidin-25 correlated with the increment of hemoglobin after 6 months (r(2) = 0.49; p < 0.01). The findings convincingly suggest that hepcidin-25 may be useful in predicting erythropoietin responsiveness in stable chronic heart failure patients. However, further studies will be needed to establish clinically available methods to reliably measure hepcidin-25 level.
铁调素是控制铁在肠道吸收及在体内分布的关键调节因子。范德普滕等人的文章研究了在未接受过促红细胞生成素治疗、铁储备充足的慢性心力衰竭和慢性肾病患者中，铁调素-25与促红细胞生成素反应性及炎症之间的关联。一项横断面观察显示，与健康受试者相比，血清铁调素-25升高了近两倍。铁调素-25与血红蛋白呈负相关（r² = 0.18；p < 0.02），与铁蛋白呈正相关（r² = 0.51；p < 0.01）以及与转铁蛋白饱和度呈正相关（r² = 0.14；p < 0.03），而与白细胞介素-6和高敏C反应蛋白水平无相关性。他们发现，为期2周的促红细胞生成素治疗（50国际单位/千克/周）显著降低了铁调素-25水平。铁调素-25水平的下降幅度与网织红细胞的增加（r² = 0.23；p < 0.03）和可溶性转铁蛋白受体的增加（r² = 0.23；p = 0.03）相关，但与炎症标志物无关。铁调素-25的下降与6个月后血红蛋白的增加相关（r² = 0.49；p < 0.01）。这些发现令人信服地表明，铁调素-25可能有助于预测稳定的慢性心力衰竭患者对促红细胞生成素的反应性。然而，需要进一步研究以建立临床上可用的可靠测量铁调素-25水平的方法。
