Przybylowski P, Koc-Zorawska E, Glowinska I, Levin-Iaina N, Macdougall I C, Malyszko J S, Mysliwiec M, Malyszko J
Cardiovascular Surgery and Transplantology, Jagiellonian University, Krakow, Poland.
Transplant Proc. 2013 Jan-Feb;45(1):391-3. doi: 10.1016/j.transproceed.2012.02.041.
Hemojuvelin plays an essential role in the regulation of hepcidin expression, specifically in the iron-sensing pathway. Dietary iron sensing and inflammatory pathways converge in the regulation of the key regulator hepcidin. Hepcidin is a small defensin-like peptide whose production by hepatocytes is modulated in response to anemia, hypoxia, or inflammation. We studied correlations of hemojuvelin with markers of iron status and of inflammation among 61 prevalent kidney allograft recipients and 136 prevalent heart transplant recipients.
Complete blood count, urea, serum lipids, fasting glucose, and creatinine were measured using standard laboratory methods in the central laboratory of the hospital. Hepcidin, soluble transferin receptor (sTFR), interleukin-6 (IL-6) and hemojuvelin were assayed by enzyme immunosorbent assay using commercially available kits.
Among heart transplant recipients hemojuvelin correlated strongly with kidney function, transferrin saturation and white blood cell count; moderately with red blood cell count, hepcidin, IL-6, high-sensitivity C-reactive protein (hsCRP) and weakly with sTfR. Multiple regression analysis revealed the predictors of hemojuvelin to be kidney function and TSAT, explaining 79% of the variations among hemojuvelin values in heart transplant recipients. Among kidney transplant recipients hemojuvelin correlated with kidney function, TSAT, hepcidin and hsCRP, and tended to correlate with IL-6. Predictors of hemojuvelin on multiple regression analysis were TSAT and creatinine.
Elevated hemojuvelin as well as hepcidin levels in kidney or heart transplant recipients may be due to the impaired kidney function and disturbed iron status frequently encountered among this population.
血色素沉着症相关蛋白在调节铁调素表达中起关键作用，特别是在铁感应途径中。膳食铁感应和炎症途径在关键调节因子铁调素的调节中相互汇聚。铁调素是一种小的防御素样肽，肝细胞产生铁调素的过程会因贫血、缺氧或炎症而受到调节。我们研究了61名肾移植受者和136名心脏移植受者中血色素沉着症相关蛋白与铁状态标志物和炎症标志物之间的相关性。
在医院的中心实验室使用标准实验室方法测量全血细胞计数、尿素、血脂、空腹血糖和肌酐。使用市售试剂盒通过酶联免疫吸附测定法检测铁调素、可溶性转铁蛋白受体（sTFR）、白细胞介素-6（IL-6）和血色素沉着症相关蛋白。
在心脏移植受者中，血色素沉着症相关蛋白与肾功能、转铁蛋白饱和度和白细胞计数密切相关；与红细胞计数、铁调素、IL-6、高敏C反应蛋白（hsCRP）中度相关，与sTfR弱相关。多元回归分析显示，肾功能和转铁蛋白饱和度是血色素沉着症相关蛋白的预测因子，可解释心脏移植受者血色素沉着症相关蛋白值变化的79%。在肾移植受者中，血色素沉着症相关蛋白与肾功能、转铁蛋白饱和度、铁调素和hsCRP相关，并倾向于与IL-6相关。多元回归分析中血色素沉着症相关蛋白的预测因子是转铁蛋白饱和度和肌酐。
肾或心脏移植受者血色素沉着症相关蛋白和铁调素水平升高可能是由于该人群中常见的肾功能受损和铁状态紊乱。
