Changes in serum hepcidin levels in children with inflammatory bowel disease during anti‐inflammatory treatment

Abstract

Aim The aim of this study was to compare changes in serum hepcidin levels in paediatric patients with inflammatory bowel disease during therapy and correlate them with markers of iron metabolism, inflammation and type of treatment. Methods Children with newly diagnosed Crohn's disease (CD) and ulcerative colitis (UC) were included in this longitudinal study. Blood and stool samples were collected to assess levels of serum hepcidin and markers of iron metabolism parameters and inflammation. The parameters were examined before treatment (baseline levels) and compared with levels in the follow‐up period during maintenance therapy (mean follow‐up of 39 months after diagnosis). Results Patients with CD (n = 30) had higher serum hepcidin levels (expressed as a median and interquartile range) at diagnosis than subjects with UC (n = 13). These levels significantly decreased during the follow‐up (from 36.5 (11.5–79.6) to 2.1 (0.9–6.7) ng/mL). In contrast, no significant serum hepcidin level changes were observed in the UC patients (5.4 (3.4–16.6) vs. 4.8 (0.9–8.1) ng/mL). While hepcidin level changes correlated with disease activity and inflammatory parameters (erythrocyte sedimentation rate, C‐reactive protein), in CD patients, they correlated only with serum iron levels in patients with UC. Biological therapy was accompanied by a significant decrease in C‐reactive protein and interleukin‐6 compared to conventional anti‐inflammatory therapy in CD patients. Conclusions Children with CD had higher serum hepcidin levels on diagnosis compared to subjects with UC. During an anti‐inflammatory therapy, serum hepcidin decreased in the CD group but remained consistently low in children with UC.

Relation of Antioxidant Native Thiol Level with Inflammatory Markers and Disease Activity Index in Pediatric Ulcerative Colitis

“…Karaskova et al (25) also demonstrated that in pediatric IBD patients the level of IL-6 decreased after treatment. Our study results about IL-6 were parallel to the findings of pediatric and adult studies in literature (24,25).…”

Hepcidin and Iron Status in Patients With Inflammatory Bowel Disease Undergoing Induction Therapy With Vedolizumab or Infliximab

“…This decrease was significant in patients who responded to the treatment compared with those who did not. 30 , 32 , 38 , 39 Likewise, these trends were observed in other patient populations (eg, in patients with rheumatoid arthritis). 40 Because most iron indices are also acute-phase proteins (ie, inflammation increases ferritin and decreases transferrin), previous data and our findings suggest that appropriate anti-inflammatory treatment during phases of active IBD can reduce hepcidin levels and, consequently, might improve the bioavailability of iron supplements.…”

Lactoferrin for iron-deficiency anemia in children with inflammatory bowel disease: a clinical trial

“…IL-6 increases gene transcription of hepcidin and decreases the gene expression of ferroportin and therefore decreases intestinal iron absorption. 21 , 22 …”