Hepcidin in Anemia of Chronic Disease

 

Structure: 25 amino acids, rich in disulfides

 

Production of hepcidin is increased in systemic inflammatory reactions due to the effects of cytokines, especially IL-6.

 

Hepcidin binds to ferroportin-1, resulting in its degradation. This results in:

(1) decreased absorption of iron from the gastrointestinal tract into plasma

(2) decreased release of iron from iron stores into plasma

 

Features of anemia of chronic disease:

(1) anemia with low serum iron and high ferritin

(2) elevated plasma hepcidin levels

(3) systemic disorder with release of cytokines

(4) poor response to erythropoietin (partially because of cytokines and partially because of the functional iron deficiency)

 

Perhaps this explains the efficacy of parenteral iron administration.