Ozkasap Serdar, Yarali Nese, Isik Pamir, Bay Ali, Kara Abdurrahman, Tunc Bahattin
Division of Pediatric Hematology and Oncology, Rize University Education and Research Hospital, Rize, Turkey.
Pediatr Hematol Oncol. 2013 Aug;30(5):425-31. doi: 10.3109/08880018.2013.783144. Epub 2013 Apr 5.
Hepcidin, a key regulator of iron homeostasis, increases when inflammation and some infections occur. It plays a critical role in macrophage iron retention, which underlies inflammation/infection caused anemia. It is known that Helicobacter pylori (HP) may lead to iron deficiency (ID) due to occult blood loss or reduced iron absorption. This study investigates the role of prohepcidin, hepcidin's precursor, in ID and ID anemia (IDA) with a concurrent HP infection.
In this prospectively designed study, 15 patients with IDA and a concurrent HP infection (group 1), 11 patients with an ID and a concurrent HP infection (group 2), and 18 patients with HP infection (group 3) were observed. All groups received only HP eradication therapy. Twenty-five age- and sex-matched children without ID/IDA and HP infection were included in the study as the control group. In all groups and control group, measurements were taken for pre- and posttreatment hemoglobin, serum prohepcidin, serum ferritin, serum iron (SI), transferrin saturation, erythrocyte sedimentation rate, fibrinogen, and C-reactive protein levels.
The pretreatment prohepcidin levels were significantly higher only in group 1 compared to the control group (P < .05). In group 1, a significant increase in hemoglobin and SI levels and a significant reduction in prohepcidin levels were additionally observed following HP eradication treatment (P < .05). However, in groups 2 and 3, significant differences in hemoglobin, iron, and prohepcidin levels between pre- and posttreatment were not observed.
Elevated serum prohepcidin might indicate the role of inflammation in the etiology of anemia concurrent with HP.
铁调素是铁稳态的关键调节因子,在炎症和某些感染发生时会升高。它在巨噬细胞铁潴留中起关键作用,这是炎症/感染所致贫血的基础。已知幽门螺杆菌(HP)可能因隐匿性失血或铁吸收减少导致缺铁(ID)。本研究调查了铁调素原(铁调素的前体)在合并HP感染的ID和缺铁性贫血(IDA)中的作用。
在这项前瞻性设计的研究中,观察了15例合并HP感染的IDA患者(第1组)、11例合并HP感染的ID患者(第2组)和18例HP感染患者(第3组)。所有组仅接受HP根除治疗。25名年龄和性别匹配、无ID/IDA及HP感染的儿童被纳入研究作为对照组。对所有组和对照组治疗前后的血红蛋白、血清铁调素原、血清铁蛋白、血清铁(SI)、转铁蛋白饱和度、红细胞沉降率、纤维蛋白原和C反应蛋白水平进行测量。
仅第1组治疗前的铁调素原水平显著高于对照组(P <.05)。在第1组中,HP根除治疗后还观察到血红蛋白和SI水平显著升高,铁调素原水平显著降低(P <.05)。然而,在第2组和第3组中,治疗前后血红蛋白、铁和铁调素原水平未观察到显著差异。
血清铁调素原升高可能表明炎症在合并HP的贫血病因中起作用。