Correlations between Serum prohepcidin level disease activity in rheumatoid arthritis and systemic lupus erythematous

Background: The incidence rate of anemia of chronic disease (ACD) in systemic lupus erythematosus (SLE) ranges between 30 and 80%. Serum iron is the main regulator of hepatic hepcidin production. Interleukin-6 (IL-6) upregulates hepcidin expression. The aim of this study is to compare between serum hepcidin and IL-6 in SLE patients and control subjects, and to find out if they are correlated with each other and with disease activity in order to find their role in treatment of anemia in SLE patients. The study was carried out on 50 SLE patients, suffering from anemia, diagnosed according to SLICC revision of the ACR classification criteria for SLE, and 50 healthy individuals, taken as control. Disease activity was assessed using the SLE disease activity index (SLEDAI-2 K). Serum hepcidin and IL-6 were measured by ELISA kit. Results: There was a highly statistically significant difference in serum hepcidin and IL-6 levels between patients and control subjects. There was a statistically significant correlation between serum hepcidin and IL-6 in SLE patients. Moreover, both of them were correlated with SLEDAI and ESR and negatively correlated with hemoglobin. The mean value of serum hepcidin in SLE patients with normocytic normochromic anemia was higher than that in patients with microcytic hypochromic anemia. However, this difference did not reach a statistically significant level. Conclusion: High serum IL-6 and hepcidin levels are associated with anemia in SLE. They are correlated with each other and with disease activity. Although our study revealed serum hepcidin to be correlated with disease activity, it should not be used as a marker of disease activity in SLE patients as our patient's group was SLE patients suffering from ACD. However, IL-6 inhibition should be considered in patients with SLE with anemia to guide the control of anemia of chronic diseases resulting from cytokine production as a result of high disease activity in SLE patients. It should be noted that the occurrence of ACD associated with IL-6 flare up could be a player in other systemic rheumatic diseases and is not specific to SLE patients.

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“…Ganeb et al concluded that prohepcidin may play a role in ACD occurring in autoimmune diseases, such as RA and SLE [33].…”

Section: Discussionmentioning

confidence: 99%

Serum hepcidin and interleukin-6 in systemic lupus erythematosus patients: crucial factors for correction of anemia

El-Shafey

Kamel

Fikry

et al. 2020

Egypt Rheumatol Rehabil

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“…Levels of serum hepcidin and prohepcidin are significantly higher in patients with inflammatory bowel disease [21], in patients with active systemic lupus erythematosus [22] , and rheumatoid arthritis [23,24]. According to [4], treatment with infliximab in patients with AS led not only to a decrease in the concentration of IL-6 and TNF-α, but also to a decrease in serum hepcidin levels and to reduction of anemia symptoms.…”

Section: Discussionmentioning

confidence: 99%

Level of Hepcidine in Patients With Ankylosing Spondylitis, Association With Anemia and the Severity of the Disease

et al. 2020

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The aim: To assess the level of hepcidin in patients with AS, to determine its connection to the disease and various forms of anemia. Materials and methods: 118 patients with ankylosing spondylitis were examined and hematological, biochemical, immunologic indicators of the general parameters of hematopoiesis and ferrokinetics, plasma levels of CRP, IL-6 and hepcidin were determined. Results: It was found that high levels of hepcidin are found in 25% of patients with AS, 50% are limiting and only 25% are optimal. The serum levels of hepcidin in patients with AS are independent of the age, sex, and duration of the disease, but are closely associated with the activity (ESR, CRP, IL-6, BASDAI, and ASDAS levels) of the disease. Close pathogenetic connection of hepcidin with the formation of anemic syndrome was established. Patients with ACD were characterized by the highest levels of hepcidin. Conclusions: Hepcidin plays an important role in the pathogenesis of ACD in patients with AS and can be used as a diagnostic marker for differential diagnosis.

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Correlations between Serum prohepcidin level disease activity in rheumatoid arthritis and systemic lupus erythematous

Cited by 2 publications

References 24 publications

Serum hepcidin and interleukin-6 in systemic lupus erythematosus patients: crucial factors for correction of anemia

Serum hepcidin and interleukin-6 in systemic lupus erythematosus patients: crucial factors for correction of anemia

Level of Hepcidine in Patients With Ankylosing Spondylitis, Association With Anemia and the Severity of the Disease

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