title: Increase of hepcidin plasma and urine levels is associated with acute proctitis and changes in hemoglobin levels in primary radiotherapy for prostate cancer.
abstract: OBJECTIVE
  To analyse hepcidin serum and urine levels during radiotherapy for prostate cancer.
  
  
  METHODS
  In 18 patients undergoing radiotherapy for prostate cancer, blood, plasma, and urine samples were taken before and during radiotherapy. Complete blood cell count, pro-hepcidin-, ferritin-, transferrin-, IL-1beta-, IL-6-, and TNF-alpha concentration was determined. Pro-hepcidin concentration was additionally measured in urine samples. Toxicity was evaluated weekly. Differences among tested factors were tested by Wilcoxon rank sign test for paired data.
  
  
  RESULTS
  In ten patients developing acute radiation-induced proctitis, a significant increase in pro-hepcidin, IL-6, and TNF-alpha plasma levels (p < 0.05) was detected. Pro-hepcidin urine levels also showed a strong trend towards increase (p = 0.06). Concurrently, hemoglobin, and leucocytes were significantly decreased in the patients with acute proctitis (p < 0.05). In eight patients showing no symptoms of proctitis, solely a significant decrease for leucocytes was detected. Additive, these patients showed a significant increase of ferritin, and a decrease of transferrin levels (p < 0.05).
  
  
  CONCLUSIONS
  Hepcidin levels are increased and hemoglobin is decreased during radiotherapy for prostate cancer in patients who develop acute proctitis. Radiation-induced expression of cytokines may be responsible for increased hepcidin expression in the liver. Regulation of iron metabolism by hepcidin may be an underestimated response in radiotherapy.
authors: Department of Radiation Oncology, University Hospital Goettingen, Robert-Koch-Strasse 40, 37099 Goettingen, Germany. hchrist@gwdg.de
authors: Hans
authors: H
authors: Christiansen
authors: Bernhard
authors: B
authors: Saile
authors: Robert M
authors: RM
authors: Hermann
authors: Margret
authors: M
authors: Rave-Fränk
authors: Andrea
authors: A
authors: Hille
authors: Heinz
authors: H
authors: Schmidberger
authors: Clemens F
authors: CF
authors: Hess
authors: Giuliano
authors: G
authors: Ramadori
mesh_terms: D000208:Acute Disease; D000230:Adenocarcinoma / Q000378:metabolism / Q000532:radiotherapy*; D000368:Aged; D023181:Antimicrobial Cationic Peptides / Q000097:blood / Q000652:urine; D006454:Hemoglobins / Q000378:metabolism*; D064451:Hepcidins; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011349:Proctitis / Q000097:blood* / Q000652:urine*; D011471:Prostatic Neoplasms / Q000378:metabolism / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology / Q000378:metabolism*; D011878:Radiotherapy / Q000009:adverse effects; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D023181:Antimicrobial Cationic Peptides; C578702:HAMP protein, human; D006454:Hemoglobins; D064451:Hepcidins; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha