Erythroferrone Expression in Anemic Rheumatoid Arthritis Patients: Is It Disordered Iron Trafficking or Disease Activity?

Soha R Youssef,1 Esraa H Hassan,2 Caroline S Morad,3 Adel A Elazab Elged,1,4 Rasha A El-Gamal1 1Clinical Pathology Department, Ain Shams University, Cairo, Egypt; 2Regional Blood Transfusion Center, Cairo, Egypt; 3Internal Medicine and Rheumatology Department, Ain Shams University, Cairo, Egypt; 4Ga...

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Autores principales:	Youssef SR, Hassan EH, Morad CS, Elazab Elged AA, El-Gamal RA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	anemia of chronic disease hepcidin iron das28. Pathology RB1-214 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/3be62737398043ea9677111465936118
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spelling	oai:doaj.org-article:3be62737398043ea96771114659361182021-12-02T19:12:05ZErythroferrone Expression in Anemic Rheumatoid Arthritis Patients: Is It Disordered Iron Trafficking or Disease Activity?1178-7031https://doaj.org/article/3be62737398043ea96771114659361182021-09-01T00:00:00Zhttps://www.dovepress.com/erythroferrone-expression-in-anemic-rheumatoid-arthritis-patients-is-i-peer-reviewed-fulltext-article-JIRhttps://doaj.org/toc/1178-7031Soha R Youssef,1 Esraa H Hassan,2 Caroline S Morad,3 Adel A Elazab Elged,1,4 Rasha A El-Gamal1 1Clinical Pathology Department, Ain Shams University, Cairo, Egypt; 2Regional Blood Transfusion Center, Cairo, Egypt; 3Internal Medicine and Rheumatology Department, Ain Shams University, Cairo, Egypt; 4Galala University, Suez, EgyptCorrespondence: Rasha A El-GamalFaculty of Medicine, Ain Shams University, Abbasseya, Cairo, EgyptTel +20 1145405005Email rashaelgamal@med.asu.edu.egPurpose: Erythroferrone (ERFE) is well acknowledged for its inhibitory function on hepcidin synthesis in the liver during stress erythropoiesis, thereby ensuring sufficient iron supply to bone marrow erythroblasts. Hepcidin plays an indispensable role in the pathogenesis of anemia of chronic disease (ACD). Thus, ERFE was suggested to protect against ACD in various diseases. Rheumatoid arthritis (RA) is commonly involved with ACD and high hepcidin levels, with a further increase of the latter in active states. The present study is a case-control study that aimed to determine the pattern of ERFE expression in RA patients with concomitant ACD and study its relationship with hepcidin, erythropoietin (EPO) and disease activity.Patients and Methods: Fifty-five RA patients with ACD were categorized into active and inactive RA using the disease activity score (DAS28); 15 healthy subjects were included as control subjects. ERFE was measured for patients and control subjects using quantitative real-time polymerase chain reaction, in addition to testing for CBC, ESR, CRP, iron profile parameters and hepcidin. EPO was assessed for patients of both active and inactive RA groups.Results: ERFE and hepcidin showed the highest levels in active RA; ERFE values were similar in control subjects and inactive RA patients, while hepcidin was significantly higher in inactive RA than control subjects. Patients with high ERFE levels had higher RBC, Hct, MCV, hepcidin and EPO levels. Stepwise regression analysis has identified DAS28 and disease duration as the best predictors of ERFE values, whereas ERFE and hepcidin were independent predictors of disease activity.Conclusion: We introduce ERFE as a novel marker of RA activity. Although the inhibitory effect of ERFE on hepcidin is not evident, our results still indicate that ERFE may have a beneficial erythropoietic effect in the context of ACD in RA disease activity.Keywords: erythroferrone, rheumatoid arthritis, anemia of chronic disease, hepcidin, iron, DAS28Youssef SRHassan EHMorad CSElazab Elged AAEl-Gamal RADove Medical Pressarticleanemia of chronic diseasehepcidinirondas28.PathologyRB1-214Therapeutics. PharmacologyRM1-950ENJournal of Inflammation Research, Vol Volume 14, Pp 4445-4455 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	anemia of chronic disease hepcidin iron das28. Pathology RB1-214 Therapeutics. Pharmacology RM1-950
spellingShingle	anemia of chronic disease hepcidin iron das28. Pathology RB1-214 Therapeutics. Pharmacology RM1-950 Youssef SR Hassan EH Morad CS Elazab Elged AA El-Gamal RA Erythroferrone Expression in Anemic Rheumatoid Arthritis Patients: Is It Disordered Iron Trafficking or Disease Activity?
description	Soha R Youssef,1 Esraa H Hassan,2 Caroline S Morad,3 Adel A Elazab Elged,1,4 Rasha A El-Gamal1 1Clinical Pathology Department, Ain Shams University, Cairo, Egypt; 2Regional Blood Transfusion Center, Cairo, Egypt; 3Internal Medicine and Rheumatology Department, Ain Shams University, Cairo, Egypt; 4Galala University, Suez, EgyptCorrespondence: Rasha A El-GamalFaculty of Medicine, Ain Shams University, Abbasseya, Cairo, EgyptTel +20 1145405005Email rashaelgamal@med.asu.edu.egPurpose: Erythroferrone (ERFE) is well acknowledged for its inhibitory function on hepcidin synthesis in the liver during stress erythropoiesis, thereby ensuring sufficient iron supply to bone marrow erythroblasts. Hepcidin plays an indispensable role in the pathogenesis of anemia of chronic disease (ACD). Thus, ERFE was suggested to protect against ACD in various diseases. Rheumatoid arthritis (RA) is commonly involved with ACD and high hepcidin levels, with a further increase of the latter in active states. The present study is a case-control study that aimed to determine the pattern of ERFE expression in RA patients with concomitant ACD and study its relationship with hepcidin, erythropoietin (EPO) and disease activity.Patients and Methods: Fifty-five RA patients with ACD were categorized into active and inactive RA using the disease activity score (DAS28); 15 healthy subjects were included as control subjects. ERFE was measured for patients and control subjects using quantitative real-time polymerase chain reaction, in addition to testing for CBC, ESR, CRP, iron profile parameters and hepcidin. EPO was assessed for patients of both active and inactive RA groups.Results: ERFE and hepcidin showed the highest levels in active RA; ERFE values were similar in control subjects and inactive RA patients, while hepcidin was significantly higher in inactive RA than control subjects. Patients with high ERFE levels had higher RBC, Hct, MCV, hepcidin and EPO levels. Stepwise regression analysis has identified DAS28 and disease duration as the best predictors of ERFE values, whereas ERFE and hepcidin were independent predictors of disease activity.Conclusion: We introduce ERFE as a novel marker of RA activity. Although the inhibitory effect of ERFE on hepcidin is not evident, our results still indicate that ERFE may have a beneficial erythropoietic effect in the context of ACD in RA disease activity.Keywords: erythroferrone, rheumatoid arthritis, anemia of chronic disease, hepcidin, iron, DAS28
format	article
author	Youssef SR Hassan EH Morad CS Elazab Elged AA El-Gamal RA
author_facet	Youssef SR Hassan EH Morad CS Elazab Elged AA El-Gamal RA
author_sort	Youssef SR
title	Erythroferrone Expression in Anemic Rheumatoid Arthritis Patients: Is It Disordered Iron Trafficking or Disease Activity?
title_short	Erythroferrone Expression in Anemic Rheumatoid Arthritis Patients: Is It Disordered Iron Trafficking or Disease Activity?
title_full	Erythroferrone Expression in Anemic Rheumatoid Arthritis Patients: Is It Disordered Iron Trafficking or Disease Activity?
title_fullStr	Erythroferrone Expression in Anemic Rheumatoid Arthritis Patients: Is It Disordered Iron Trafficking or Disease Activity?
title_full_unstemmed	Erythroferrone Expression in Anemic Rheumatoid Arthritis Patients: Is It Disordered Iron Trafficking or Disease Activity?
title_sort	erythroferrone expression in anemic rheumatoid arthritis patients: is it disordered iron trafficking or disease activity?
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/3be62737398043ea9677111465936118
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Erythroferrone Expression in Anemic Rheumatoid Arthritis Patients: Is It Disordered Iron Trafficking or Disease Activity?

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