BACKGROUND: Anemia in patients with Crohn's disease (CD) is a common problem of multifactorial origin, including blood loss, malabsorption of iron, and anemia of inflammation. Anemia of inflammation is caused by the effects of inflammatory cytokines [predominantly interleukin-6 (IL-6)] on iron transport in enterocytes and macrophages. We sought to elucidate alterations in iron absorption in pediatric patients with active and inactive CD. METHODS: Nineteen subjects with CD (8 female, 11 male patients) were recruited between April 2003 and June 2004. After an overnight fast, serum iron and hemoglobin levels, serum markers of inflammation [IL-6, C-reactive protein (CRP), and erythrocyte sedimentation rate], and a urine sample for hepcidin assay were obtained at 8 am. Ferrous sulfate (1 mg/kg) was administered orally, followed by determination of serum iron concentrations hourly for 4 hours after the ingestion of iron. An area under the curve for iron absorption was calculated for each patient data set. RESULTS: There was a strong inverse correlation between the area under the curve and IL-6 (P = 0.002) and area under the curve and CRP levels (P = 0.04). Similarly, the difference between baseline and 2-hour serum iron level (Delta[Fe]2hr) correlated with IL-6 (P = 0.008) and CRP (P = 0.045). When cutoff values for IL-6 (>5 pg/mL) and CRP (>1.0 mg/dL) were used, urine hepcidin levels also positively correlated with IL-6 and CRP levels (P = 0.003 and 0.007, respectively). CONCLUSIONS: Subjects with active CD have impaired oral iron absorption and elevated IL-6 levels compared with subjects with inactive disease. These findings suggest that oral iron may be of limited benefit to these patients. Future study is needed to define the molecular basis for impaired iron absorption.
BACKGROUND:Anemia in patients with Crohn's disease (CD) is a common problem of multifactorial origin, including blood loss, malabsorption of iron, and anemia of inflammation. Anemia of inflammation is caused by the effects of inflammatory cytokines [predominantly interleukin-6 (IL-6)] on iron transport in enterocytes and macrophages. We sought to elucidate alterations in iron absorption in pediatric patients with active and inactive CD. METHODS: Nineteen subjects with CD (8 female, 11 male patients) were recruited between April 2003 and June 2004. After an overnight fast, serum iron and hemoglobin levels, serum markers of inflammation [IL-6, C-reactive protein (CRP), and erythrocyte sedimentation rate], and a urine sample for hepcidin assay were obtained at 8 am. Ferrous sulfate (1 mg/kg) was administered orally, followed by determination of serum iron concentrations hourly for 4 hours after the ingestion of iron. An area under the curve for iron absorption was calculated for each patient data set. RESULTS: There was a strong inverse correlation between the area under the curve and IL-6 (P = 0.002) and area under the curve and CRP levels (P = 0.04). Similarly, the difference between baseline and 2-hour serum iron level (Delta[Fe]2hr) correlated with IL-6 (P = 0.008) and CRP (P = 0.045). When cutoff values for IL-6 (>5 pg/mL) and CRP (>1.0 mg/dL) were used, urine hepcidin levels also positively correlated with IL-6 and CRP levels (P = 0.003 and 0.007, respectively). CONCLUSIONS: Subjects with active CD have impaired oral iron absorption and elevated IL-6 levels compared with subjects with inactive disease. These findings suggest that oral iron may be of limited benefit to these patients. Future study is needed to define the molecular basis for impaired iron absorption.
Authors: G Nicolas; M Bennoun; I Devaux; C Beaumont; B Grandchamp; A Kahn; S Vaulont Journal: Proc Natl Acad Sci U S A Date: 2001-07-10 Impact factor: 11.205
Authors: Elizabeta Nemeth; Erika V Valore; Mary Territo; Gary Schiller; Alan Lichtenstein; Tomas Ganz Journal: Blood Date: 2002-11-14 Impact factor: 22.113
Authors: A T McKie; P Marciani; A Rolfs; K Brennan; K Wehr; D Barrow; S Miret; A Bomford; T J Peters; F Farzaneh; M A Hediger; M W Hentze; R J Simpson Journal: Mol Cell Date: 2000-02 Impact factor: 17.970
Authors: Gaël Nicolas; Myriam Bennoun; Arlette Porteu; Sandrine Mativet; Carole Beaumont; Bernard Grandchamp; Mario Sirito; Michèle Sawadogo; Axel Kahn; Sophie Vaulont Journal: Proc Natl Acad Sci U S A Date: 2002-04-02 Impact factor: 11.205
Authors: Lijian Wang; Estela Trebicka; Ying Fu; Shiri Ellenbogen; Charles C Hong; Jodie L Babitt; Herbert Y Lin; Bobby J Cherayil Journal: Inflamm Bowel Dis Date: 2011-02-23 Impact factor: 5.325
Authors: Kamran Rostami; David Aldulaimi; Geoffrey Holmes; Matt W Johnson; Marie Robert; Amitabh Srivastava; Jean-François Fléjou; David S Sanders; Umberto Volta; Mohammad H Derakhshan; James J Going; Gabriel Becheanu; Carlo Catassi; Mihai Danciu; Luke Materacki; Kamran Ghafarzadegan; Sauid Ishaq; Mohammad Rostami-Nejad; A Salvador Peña; Gabrio Bassotti; Michael N Marsh; Vincenzo Villanacci Journal: World J Gastroenterol Date: 2015-03-07 Impact factor: 5.742
Authors: Vasiliki Koliaraki; Martha Marinou; Theodoros P Vassilakopoulos; Eustathios Vavourakis; Emmanuel Tsochatzis; Gerassimos A Pangalis; George Papatheodoridis; Alexandra Stamoulakatou; Dorine W Swinkels; George Papanikolaou; Avgi Mamalaki Journal: PLoS One Date: 2009-02-24 Impact factor: 3.240