Mass spectrometry-based hepcidin measurements in serum and urine: analytical aspects and clinical implications.
BACKGROUND
Discovery of the central role of hepcidin in body iron regulation has shed new light on the pathophysiology of iron disorders. Information is lacking on newer analytical approaches to measure hepcidin in serum and urine. Recent reports on the measurement of urine and serum hepcidin by surface-enhanced laser-desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) necessitate analytical and clinical evaluation of MS-based methodologies.


METHODS
We used SELDI-TOF MS, immunocapture, and tandem MS to identify and characterize hepcidin in serum and urine. In addition to diagnostic application, we investigated analytical reproducibility and biological and preanalytical variation for both serum and urine on Normal Phase 20 and Immobilized Metal Affinity Capture 30 ProteinChip arrays. We obtained samples from healthy controls and patients with documented iron-deficiency anemia, inflammation-induced anemia, thalassemia major, and hereditary hemochromatosis.


RESULTS
Proteomic techniques showed that hepcidin-20, -22, and -25 isoforms are present in urine. Hepcidin-25 in serum had the same amino acid sequence as hepcidin-25 in urine, whereas hepcidin-22 was not detected in serum. The interarray CV was 15% to 27%, and interspot CV was 11% to 13%. Preliminary studies showed that hepcidin-25 differentiated disorders of iron metabolism. Urine hepcidin is more affected by multiple freeze-thaw cycles and storage conditions, but less influenced by diurnal variation, than is serum hepcidin.


CONCLUSIONS
SELDI-TOF MS can be used to measure hepcidin in both serum and urine, but serum requires a standardized sampling protocol.
Kemna
Erwin H J M
EH
Department of Clinical Chemistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. e.kemna@akc.umcn.nl
Tjalsma
Harold
H
Podust
Vladimir N
VN
Swinkels
Dorine W
DW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis; D023181:Antimicrobial Cationic Peptides / Q000097:blood* / Q000652:urine*; D005260:Female; D006432:Hemochromatosis / Q000175:diagnosis / Q000235:genetics; D064451:Hepcidins; D006801:Humans; D008297:Male; D008875:Middle Aged; D040081:Protein Array Analysis; D012016:Reference Values; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D013789:Thalassemia / Q000175:diagnosis
D023181:Antimicrobial Cationic Peptides; C578702:HAMP protein, human; D064451:Hepcidins