Increase of plasma erythroferrone levels during high‐altitude exposure: A sub‐analysis of the <scp>TOP OF HOMe</scp> study

Emrich, Insa E.; Scheuer, Anja L.; Wagenpfeil, Stefan; Ganz, Tomas; Heine, Gunnar H.

doi:10.1002/ajh.26130

Cited by 9 publications

(3 citation statements)

References 6 publications

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“…Iron Supplementation and the ABP Erythroferrone (ERFE) has been highlighted as a crucial endocrine regulator of erythropoiesis and iron metabolism (Emrich et al, 2021). Erythropoiesis induced by altitude exposure through s-EPO secretion stimulates the production of ERFE, leading to a decrease in the plasma hepcidin concentration, which will, in turn, disturb iron homeostasis (Robach et al, 2009;Badenhorst et al, 2014).…”

Section: Decrease In S-epo Levels After Altitude Trainingmentioning

confidence: 99%

Altitude and Erythropoietin: Comparative Evaluation of Their Impact on Key Parameters of the Athlete Biological Passport: A Review

Saugy¹,

Schmoutz²,

Botrè³

2022

Front. Sports Act. Living

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The hematological module of the Athlete's Biological Passport (ABP) identifies doping methods and/or substances used to increase the blood's capacity to transport or deliver oxygen to the tissues. Recombinant human erythropoietin (rhEPOs) are doping substances known to boost the production of red blood cells and might have an effect on the blood biomarkers of the ABP. However, hypoxic exposure influences these biomarkers similarly to rhEPOs. This analogous impact complicates the ABP profiles' interpretation by antidoping experts. The present study aimed to collect and identify, through a literature search, the physiological effects on ABP blood biomarkers induced by these external factors. A total of 43 studies were selected for this review. A positive correlation (R2 = 0.605, r = 0.778, p < 0.001) was identified between the hypoxic dose and the increase in hemoglobin concentration (HGB) percentage. In addition, the change in the reticulocyte percentage (RET%) has been identified as one of the most sensitive parameters to rhEPO use. The mean effects of rhEPO on blood parameters were greater than those induced by hypoxic exposure (1.7 times higher for HGB and RET% and 4 times higher for hemoglobin mass). However, rhEPO micro-doses have shown effects that are hardly distinguishable from those identified after hypoxic exposure. The results of the literature search allowed to identify temporal and quantitative evolution of blood parameters in connection with different hypoxic exposure doses, as well as different rhEPOs doses. This might be considered to provide justified and well-documented interpretations of physiological changes in blood parameters of the Athlete Biological Passport.

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Section: Decrease In S-epo Levels After Altitude Trainingmentioning

confidence: 99%

Altitude and Erythropoietin: Comparative Evaluation of Their Impact on Key Parameters of the Athlete Biological Passport: A Review

Saugy¹,

Schmoutz²,

Botrè³

2022

Front. Sports Act. Living

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“…However, although we observed a 35% reduction in resting hepcidin concentrations in the current study, no changes to ERFE were detected. A lack of ERFE expression is an interesting finding, particularly given previous studies have shown concentrations of this hormone peak after ~8 d of altitude exposure (31). One explanation for the lack of effect here is that the increase in EPO was insufficient to drive an increase in ERFE.…”

Section: Discussionmentioning

confidence: 91%

Iron Absorption in Highly Trained Male Runners: Does it Matter When and Where You Eat Your Iron?

MCKAY,

ANDERSON,

PEELING

et al. 2023

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose We examined iron absorption and its regulation during two common scenarios experienced by endurance athletes. Our aims were to: (i) compare the effects of preexercise versus postexercise iron intake on iron absorption; and (ii) compare the impact of training at altitude (1800 m) on iron absorption preexercise. Methods Male runners (n = 18) completed three exercise trials over a 5-wk period, each preceded by 24 h of standardized low-iron diets. First, athletes completed two 60-min treadmill running trials at 65% V̇O2max at near sea-level (580 m). In a randomized order, preexercise and postexercise test meals labeled with 4 mg of 57Fe or 58Fe were consumed 30 min before or 30 min after exercise. Then, the same exercise trial was performed after living and training at altitude (~1800 m) for 7 d, with the labeled test meal consumed 30 min preexercise. We collected venous blood samples preexercise and postexercise for markers of iron status and regulation, and 14 d later to measure erythrocyte isotope incorporation. Results No differences in fractional iron absorption were evident when test meals were consumed preexercise (7.3% [4.4, 12.1]) or postexercise (6.2% [3.1, 12.5]) (n = 18; P = 0.058). Iron absorption preexercise was greater at altitude (18.4% [10.6, 32.0]) than at near sea-level (n = 17; P < 0.001) and hepcidin concentrations at altitude were lower at rest and 3 h postexercise compared with near sea level (P < 0.001). Conclusions In an acute setting, preexercise and postexercise iron absorption is comparable if consumed within 30 min of exercise. Preexercise iron absorption increases 2.6-fold at altitude compared with near sea-level, likely due to the homeostatic response to provide iron for enhanced erythropoiesis and maintain iron stores.

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“…ERFE knockout mice are not able to suppress hepcidin in response to hemorrhage or EPO injection. The link between ERFE, hypoxia, and EPO is also demonstrated by the measurement of ERFE and EPO in healthy individuals exposed to high altitudes, where increased plasma ERFE and lower plasma hepcidin levels have been observed [ 42 ]. In contrast to iron-mediated regulation of hepcidin via the BMP-SMAD pathway, inflammation-mediated regulation occurs via the IL-6/Janus kinase (JAK)/signal transducer and activator of transcription (STAT) signaling pathways [ 43 ].…”

Section: Introductionmentioning

confidence: 99%

Interpreting Iron Homeostasis in Congenital and Acquired Disorders

et al. 2023

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Mammalian cells require iron to satisfy their metabolic needs and to accomplish specialized functions, such as hematopoiesis, mitochondrial biogenesis, energy metabolism, or oxygen transport. Iron homeostasis is balanced by the interplay of proteins responsible for iron import, storage, and export. A misbalance of iron homeostasis may cause either iron deficiencies or iron overload diseases. The clinical work-up of iron dysregulation is highly important, as severe symptoms and pathologies may arise. Treating iron overload or iron deficiency is important to avoid cellular damage and severe symptoms and improve patient outcomes. The impressive progress made in the past years in understanding mechanisms that maintain iron homeostasis has already changed clinical practice for treating iron-related diseases and is expected to improve patient management even further in the future.

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Increase of plasma erythroferrone levels during high‐altitude exposure: A sub‐analysis of the TOP OF HOMe study

Abstract: et al. Revised recommendations of the International Working Group for diagnosis, standardization of response criteria, treatment outcomes, and reporting standards for therapeutic trials in acute myeloid leukemia.

Cited by 9 publications

References 6 publications

Altitude and Erythropoietin: Comparative Evaluation of Their Impact on Key Parameters of the Athlete Biological Passport: A Review

Altitude and Erythropoietin: Comparative Evaluation of Their Impact on Key Parameters of the Athlete Biological Passport: A Review

Iron Absorption in Highly Trained Male Runners: Does it Matter When and Where You Eat Your Iron?

Interpreting Iron Homeostasis in Congenital and Acquired Disorders

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