ETH Zürich, Laboratory of Human Nutrition, Institute of Food Nutrition and Health, Department of Health Science and Technology, Zürich, Switzerland
Ibn Tofaïl University-CNESTEN, Joint Research Unit in Nutrition and Food, RDC-Nutrition AFRA/IAEA, Rabat-Kénitra, Morocco.
Haematologica. 2019 Jun;104(6):1143-1149. doi: 10.3324/haematol.2018.208645. Epub 2019 Jan 10.
Hepatic hepcidin synthesis is stimulated by inflammation but inhibited during iron deficiency anemia (IDA). In humans, the relative strength of these opposing signals on serum hepcidin and the net effect on iron absorption and systemic iron recycling is uncertain. In this prospective, 45-day study, in young women (n=46; age 18-49 years) with or without IDA, we compared iron and inflammation markers, serum hepcidin and erythrocyte iron incorporation from Fe-labeled test meals, before and 8, 24 and 36 hours (h) after influenza/DPT vaccination as an acute inflammatory stimulus. Compared to baseline, at 24-36 h after vaccination: 1) interleukin-6 increased 2-3-fold in both groups (<0.001); 2) serum hepcidin increased >2-fold in the non-anemic group (<0.001), but did not significantly change in the IDA group; 3) serum iron decreased in the non-anemic group (<0.05) but did not change in the IDA group; and 4) erythrocyte iron incorporation did not change in either of the two groups, but was approximately 2-fold higher in the IDA group both before and after vaccination (<0.001). In this study, mild acute inflammation did not increase serum hepcidin in women with IDA, suggesting low iron status and erythropoietic drive offset the inflammatory stimulus on hepcidin expression. In non-anemic women, inflammation increased serum hepcidin and produced mild hypoferremia, but did not reduce dietary iron absorption, suggesting iron-recycling macrophages are more sensitive than the enterocyte to high serum hepcidin during inflammation. The study was registered as a prospective observational trial at The study was funded by the International Atomic Energy Agency.
肝脏中的铁调素合成受到炎症的刺激，但在缺铁性贫血（IDA）时受到抑制。在人类中，这两种相反信号对血清铁调素的相对强度以及对铁吸收和全身铁循环的净影响尚不确定。在这项前瞻性、45 天的研究中，我们比较了有无 IDA 的年轻女性（n=46；年龄 18-49 岁）在流感/DPT 疫苗接种前后（作为急性炎症刺激）的铁和炎症标志物、血清铁调素和红细胞铁掺入 Fe 标记的试验餐，结果发现：1）与基线相比，在接种后 24-36 小时，两组白细胞介素-6 均增加 2-3 倍（<0.001）；2）非贫血组血清铁调素增加 2 倍以上（<0.001），但 IDA 组无明显变化；3）非贫血组血清铁减少（<0.05），但 IDA 组无变化；4）两组红细胞铁掺入均无变化，但 IDA 组接种前后均增加约 2 倍（<0.001）。在这项研究中，轻度急性炎症并未增加 IDA 女性的血清铁调素，表明低铁状态和红细胞生成驱动抵消了铁调素表达的炎症刺激。在非贫血女性中，炎症增加了血清铁调素并导致轻度低血症，但并未减少膳食铁吸收，这表明在炎症期间，铁循环巨噬细胞比肠细胞对高血清铁调素更为敏感。该研究在临床试验注册中心注册为前瞻性观察性试验。该研究由国际原子能机构资助。
