Anti-TNF-Mediated Modulation of Prohepcidin Improves Iron Availability in Inflammatory Bowel Disease, in an IL-6-Mediated Fashion
Background. Anaemia is common in inflammatory bowel disease (IBD), frequently resulting from a combination of iron deficiency and of anaemia of chronic disease (ACD). ACD is characterized by macrophage iron retention induced by proinflammatory cytokines. Hepcidin is the master inducer of iron accumu...
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| Format: | Article |
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Wiley
2017-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2017/6843976 |
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| author | Flaminia Cavallaro Lorena Duca Laura Francesca Pisani Roberta Rigolini Luisa Spina Gian Eugenio Tontini Nadia Munizio Elena Costa Maria Domenica Cappellini Maurizio Vecchi Luca Pastorelli |
| author_facet | Flaminia Cavallaro Lorena Duca Laura Francesca Pisani Roberta Rigolini Luisa Spina Gian Eugenio Tontini Nadia Munizio Elena Costa Maria Domenica Cappellini Maurizio Vecchi Luca Pastorelli |
| author_sort | Flaminia Cavallaro |
| collection | DOAJ |
| description | Background. Anaemia is common in inflammatory bowel disease (IBD), frequently resulting from a combination of iron deficiency and of anaemia of chronic disease (ACD). ACD is characterized by macrophage iron retention induced by proinflammatory cytokines. Hepcidin is the master inducer of iron accumulation during ACD, and its production is mainly regulated by IL-6 and the novel erythroid hormone erythroferrone (ERFE). This study evaluates whether anti-TNF monoclonal antibodies therapy modurates hepcidin production and the levels of its main regulators, leading to a restoration of iron homeostasis. Methods. Sera were collected from 21 IBD patients, before each anti-TNF administration, for the first 6 weeks of therapy. Prohepcidin, erythropoietin, erythroferrone, C reactive protein, interleukin-6, iron markers, and haemoglobin levels were measured and clinical activity indexes were evaluated. Results. Serum prohepcidin, IL-6, CRP, and ferritin were significantly reduced after 6-week treatment; an increase in serum iron and total transferrin was observed. No changes in the EPO-ERFE axis were found. Remarkably, haemoglobin was significantly increased. Conclusions. Anti-TNF therapy improves iron metabolism and, subsequently, anaemia in IBD. This effect appears to be related to the modulation of the cytokine network and specifically IL-6 leading to a relevant decrease of hepcidin, a master regulator of ACD. |
| format | Article |
| id | doaj-art-6b050f3683214814aa5b93a6fa992c9a |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-6b050f3683214814aa5b93a6fa992c9a2025-02-03T00:59:17ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972017-01-01201710.1155/2017/68439766843976Anti-TNF-Mediated Modulation of Prohepcidin Improves Iron Availability in Inflammatory Bowel Disease, in an IL-6-Mediated FashionFlaminia Cavallaro0Lorena Duca1Laura Francesca Pisani2Roberta Rigolini3Luisa Spina4Gian Eugenio Tontini5Nadia Munizio6Elena Costa7Maria Domenica Cappellini8Maurizio Vecchi9Luca Pastorelli10Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, ItalyDepartment of Clinical Sciences and Community, University of Milan, Milan, ItalyGastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, ItalyLaboratory Medicine Service, IRCCS Policlinico San Donato, San Donato Milanese, ItalyGastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, ItalyGastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, ItalyGastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, ItalyLaboratory Medicine Service, IRCCS Policlinico San Donato, San Donato Milanese, ItalyDepartment of Clinical Sciences and Community, University of Milan, Milan, ItalyGastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, ItalyGastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, ItalyBackground. Anaemia is common in inflammatory bowel disease (IBD), frequently resulting from a combination of iron deficiency and of anaemia of chronic disease (ACD). ACD is characterized by macrophage iron retention induced by proinflammatory cytokines. Hepcidin is the master inducer of iron accumulation during ACD, and its production is mainly regulated by IL-6 and the novel erythroid hormone erythroferrone (ERFE). This study evaluates whether anti-TNF monoclonal antibodies therapy modurates hepcidin production and the levels of its main regulators, leading to a restoration of iron homeostasis. Methods. Sera were collected from 21 IBD patients, before each anti-TNF administration, for the first 6 weeks of therapy. Prohepcidin, erythropoietin, erythroferrone, C reactive protein, interleukin-6, iron markers, and haemoglobin levels were measured and clinical activity indexes were evaluated. Results. Serum prohepcidin, IL-6, CRP, and ferritin were significantly reduced after 6-week treatment; an increase in serum iron and total transferrin was observed. No changes in the EPO-ERFE axis were found. Remarkably, haemoglobin was significantly increased. Conclusions. Anti-TNF therapy improves iron metabolism and, subsequently, anaemia in IBD. This effect appears to be related to the modulation of the cytokine network and specifically IL-6 leading to a relevant decrease of hepcidin, a master regulator of ACD.http://dx.doi.org/10.1155/2017/6843976 |
| spellingShingle | Flaminia Cavallaro Lorena Duca Laura Francesca Pisani Roberta Rigolini Luisa Spina Gian Eugenio Tontini Nadia Munizio Elena Costa Maria Domenica Cappellini Maurizio Vecchi Luca Pastorelli Anti-TNF-Mediated Modulation of Prohepcidin Improves Iron Availability in Inflammatory Bowel Disease, in an IL-6-Mediated Fashion Canadian Journal of Gastroenterology and Hepatology |
| title | Anti-TNF-Mediated Modulation of Prohepcidin Improves Iron Availability in Inflammatory Bowel Disease, in an IL-6-Mediated Fashion |
| title_full | Anti-TNF-Mediated Modulation of Prohepcidin Improves Iron Availability in Inflammatory Bowel Disease, in an IL-6-Mediated Fashion |
| title_fullStr | Anti-TNF-Mediated Modulation of Prohepcidin Improves Iron Availability in Inflammatory Bowel Disease, in an IL-6-Mediated Fashion |
| title_full_unstemmed | Anti-TNF-Mediated Modulation of Prohepcidin Improves Iron Availability in Inflammatory Bowel Disease, in an IL-6-Mediated Fashion |
| title_short | Anti-TNF-Mediated Modulation of Prohepcidin Improves Iron Availability in Inflammatory Bowel Disease, in an IL-6-Mediated Fashion |
| title_sort | anti tnf mediated modulation of prohepcidin improves iron availability in inflammatory bowel disease in an il 6 mediated fashion |
| url | http://dx.doi.org/10.1155/2017/6843976 |
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