Lemos Andrea dos Reis, Ismael Lorene Aparecida Silva, Boato Claudia Carvalho Maltese, Borges Maria Tereza Frota, Rondó Patricia Helen de Carvalho
Faculdade de Ciências Farmacêuticas da Universidade de São Paulo, São Paulo, SP, Brazil.
Rev Assoc Med Bras (1992). 2010 Sep-Oct;56(5):596-9. doi: 10.1590/s0104-42302010000500024.
Iron deficiency anemia is the most prevalent nutritional disorder in the world. Information on the metabolism of hepcidin and its possible significance as a biochemical parameter in iron deficiency anemia is reported in this review, which was based on a survey of the databases PubMed and LILACS for articles published between 2006 and 2010 on hepcidin as a biomarker for the regulation of iron metabolism. The literature search returned 35 studies published in international journals and one study on the subject in a Brazilian journal. Hepcidin production is homeostatically regulated by anemia and hypoxia. When oxygen delivery is inadequate, hepcidin levels decrease. Consequently, more iron is made available from the diet and from the storage pool in macrophages and hepatocytes. Hepcidin binds to ferroportin, regulating iron release into plasma. When hepcidin concentrations are low, ferroportin molecules are displayed on the plasma membrane and release iron. When hepcidin levels increase, hepcidin binds to ferroportin molecules inducing their internalization and degradation, and iron release is decreased progressively. Apparently, the development of diagnosis and therapy for anemia based on the bioindicator hepcidin may provide a more effective approach. Epidemiological studies are needed to demonstrate the relevance of hepcidin to the differential diagnosis of anemia, including sampling protocols for analysis, with standardization similar to that used in other biochemical assessments, and establishment of cutoff points for urinary and plasma expression of this peptide.
缺铁性贫血是世界上最普遍的营养失调症。本综述报道了关于铁调素代谢及其作为缺铁性贫血生化参数的可能意义的信息，该综述基于对数据库PubMed和LILACS的调查，以获取2006年至2010年间发表的关于铁调素作为铁代谢调节生物标志物的文章。文献检索返回了35项发表在国际期刊上的研究以及1项巴西期刊上关于该主题的研究。铁调素的产生受贫血和缺氧的稳态调节。当氧气输送不足时，铁调素水平降低。因此，从饮食以及巨噬细胞和肝细胞的储存池中可获得更多的铁。铁调素与铁转运蛋白结合，调节铁释放到血浆中。当铁调素浓度低时，铁转运蛋白分子显示在质膜上并释放铁。当铁调素水平升高时，铁调素与铁转运蛋白分子结合，诱导其内化和降解，铁释放逐渐减少。显然，基于生物指示剂铁调素开发贫血的诊断和治疗方法可能会提供一种更有效的途径。需要进行流行病学研究，以证明铁调素与贫血鉴别诊断的相关性，包括分析的采样方案，采用与其他生化评估类似的标准化方法，并确定该肽在尿液和血浆中表达的临界值。
