Respiratory infections drive hepcidin-mediated blockade of iron absorption leading to iron deficiency anemia in African children.

Autor: Prentice AM; MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia., Bah A; MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia., Jallow MW; MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia., Jallow AT; MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia., Sanyang S; MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia., Sise EA; MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia., Ceesay K; MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia., Danso E; MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia., Armitage AE; MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK., Pasricha SR; Walter and Eliza Hall Institute for Medical Research, 1G Royal Parade, Melbourne, Parkville, Victoria 3052, Australia., Drakesmith H; MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK., Wathuo M; MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia., Kessler N; MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia.; Department of Genetics, University of Cambridge, Cambridge, UK., Cerami C; MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia., Wegmüller R; MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia.; GroundWork, 7306 Fläsch, Switzerland.; Human Nutrition Laboratory, Institute of Food, Nutrition and Health, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
Jazyk: angličtina
Zdroj: Science advances [Sci Adv] 2019 Mar 27; Vol. 5 (3), pp. eaav9020. Date of Electronic Publication: 2019 Mar 27 (Print Publication: 2019).
DOI: 10.1126/sciadv.aav9020
Abstrakt: Iron deficiency anemia (IDA) is the most prevalent nutritional condition worldwide. We studied the contribution of hepcidin-mediated iron blockade to IDA in African children. We measured hepcidin and hemoglobin weekly, and hematological, inflammatory, and iron biomarkers at baseline, 7 weeks, and 12 weeks in 407 anemic (hemoglobin < 11 g/dl), otherwise healthy Gambian children (6 to 27 months). Each child maintained remarkably constant hepcidin levels ( P < 0.0001 for between-child variance), with half consistently maintaining levels that indicate physiological blockade of iron absorption. Hepcidin was strongly predicted by nurse-ascribed adverse events with dominant signals from respiratory infections and fevers (all P < 0.0001). Diarrhea and fecal calprotectin were not associated with hepcidin. In multivariate analysis, C-reactive protein was the dominant predictor of hepcidin and contributed to iron blockade even at very low levels. We conclude that even low-grade inflammation, especially associated with respiratory infections, contributes to IDA in African children.
Databáze: MEDLINE