Langer Arielle L, Ginzburg Yelena Z
Division of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Hemodial Int. 2017 Jun;21 Suppl 1(Suppl 1):S37-S46. doi: 10.1111/hdi.12543. Epub 2017 Mar 22.
Anemia of chronic inflammation (ACI) is a frequently diagnosed anemia and portends an independently increased morbidity and poor outcome associated with multiple underlying diseases. The pathophysiology of ACI is multifactorial, resulting from the effects of inflammatory cytokines which both directly and indirectly suppress erythropoiesis. Recent advances in molecular understanding of iron metabolism provide strong evidence that immune mediators, such as IL-6, lead to hepcidin-induced hypoferremia, iron sequestration, and decreased iron availability for erythropoiesis. The role of hepcidin-ferroportin axis in the pathophysiology of ACI is stimulating the development of new diagnostics and targeted therapies. In this review, we present an overview of and rationale for inflammation-, iron-, and erythropoiesis-related strategies currently in development.
慢性炎症性贫血(ACI)是一种常见的诊断出的贫血症,预示着与多种潜在疾病相关的独立发病率增加和不良预后。ACI的病理生理学是多因素的,由炎症细胞因子的作用导致,这些细胞因子直接或间接抑制红细胞生成。铁代谢分子理解方面的最新进展提供了有力证据,表明免疫介质如白细胞介素-6会导致铁调素诱导的低铁血症、铁螯合以及红细胞生成可用铁减少。铁调素-铁转运蛋白轴在ACI病理生理学中的作用正在推动新诊断方法和靶向治疗的发展。在本综述中,我们概述了目前正在开发的与炎症、铁和红细胞生成相关策略及其原理。