Han Xiao, Zhou Dao-Bin, Duan Ming-Hui, Wang Xuan, Zhang Jie-Ping, Zhao Yong-Qiang, Shen Ti, Wu Yong-Ji
Department of Hematology, Chinese Academy of Medical Sciences, Beijing, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2013 Apr;21(2):403-9. doi: 10.7534/j.issn.1009-2137.2013.02.030.
Disorders of iron utilization caused by abnormal elevation of hepcidin levels are the main mechanism of anemia of chronic disease. Hepcidin is mainly produced by the liver. Recently it has been found that monocytes are another source of hepcidin. The increased hepcidin in serum and urine of multiple myeloma patients may be one cause of anemia of chronic disease (ACD). However it is unclear whether the peripheral blood monocyte hepcidin is involved in the pathogenesis of anemia of chronic disease. This study was purposed to investigate the role of monocyte hepcidin in multiple myeloma patients with anemia of chronic disease. The clinical data and peripheral venous blood of multiple myeloma patients were collected.Serum concentration of IL-6 and TNF-α was detected by ELISA. Peripheral blood monocytes were isolated by CD14(+) magnetic beads. Hepcidin, IL-6 and TNF-α mRNA of monocytes were detected by real time quantitative PCR. The results showed that the expression level of monocyte hepcidin mRNA in myeloma patients was higher than that in normal controls. In untreated patients, the expression level of monocyte hepcidin mRNA was negatively correlated with hemoglobin, and positively correlated with serum ferritin and IL-6 levels, but unrelated with TNF-α levels.It is concluded that the increased monocyte hepcidin levels in multiple myeloma patients may play an etiologic role in ACD.
铁调素水平异常升高导致的铁利用障碍是慢性病贫血的主要机制。铁调素主要由肝脏产生。最近发现单核细胞是铁调素的另一个来源。多发性骨髓瘤患者血清和尿液中铁调素增加可能是慢性病贫血(ACD)的原因之一。然而,外周血单核细胞铁调素是否参与慢性病贫血的发病机制尚不清楚。本研究旨在探讨单核细胞铁调素在多发性骨髓瘤合并慢性病贫血患者中的作用。收集多发性骨髓瘤患者的临床资料和外周静脉血。采用ELISA法检测血清IL-6和TNF-α浓度。通过CD14(+)磁珠分离外周血单核细胞。采用实时定量PCR检测单核细胞铁调素、IL-6和TNF-α mRNA。结果显示,骨髓瘤患者单核细胞铁调素mRNA表达水平高于正常对照组。在未治疗患者中,单核细胞铁调素mRNA表达水平与血红蛋白呈负相关,与血清铁蛋白和IL-6水平呈正相关,但与TNF-α水平无关。结论:多发性骨髓瘤患者单核细胞铁调素水平升高可能在ACD的发病中起病因学作用。