title: Measurement of urinary hepcidin levels by SELDI-TOF-MS in HFE-hemochromatosis.
abstract: BACKGROUND
  Insufficient production of hepcidin, the master regulator of iron metabolism, is recognized as the key pathogenetic feature of HFE-related hereditary hemochromatosis (HH). There is a growing interest in measuring the hepcidin levels, which may improve the diagnosis, prognostic evaluation and clinical management of HH. Nevertheless, few investigative tools are available: an immunodot method for urinary hepcidin developed by a single centre (UCLA), not yet ready for large-scale diffusion, and mass spectrometry (MS) based assays, such as surface-enhanced laser desorption/ionization time-of-flight (SELDI-TOF-MS). The latter is well suited to small peptides like hepcidin, and can rapidly analyze crude samples with high throughput. This study measured urinary hepcidin levels by SELDI-TOF-MS in a large group of HH patients at diagnosis and during treatment, including both C282Y homozygous and C282Y/H63D compound heterozygotes.
  
  
  METHODS
  We used a protocol based on PBSIIc mass spectrometer and Normal Phase chips. Urinary samples from 30 control subjects were compared to those obtained from 80 HH patients (57 C282Y homozygotes, 23 C282Y/H63D compound heterozygotes). Eighteen C282Y homozygotes and 11 C282Y/H63D compound heterozygotes were analyzed at diagnosis, the remainder during maintenance phlebotomy.
  
  
  RESULTS
  C282Y homozygotes either at diagnosis, or after phlebotomy had significantly lower urinary hepcidin levels than controls (P<0.05). C282Y/H63D compound heterozygotes had hepcidin levels at diagnosis higher than controls, while the hepcidin/ferritin ratio was significantly decreased (P<0.001) suggesting inadequate hepcidin production. After phlebotomy, mean hepcidin levels in the compound heterozygotes were significantly lower than in controls (P<0.001). Samples from 12 randomly selected control subjects were sent to UCLA for duplicate measurement by the immunodot method, yielding a significant correlation (rho=0.64; P=0.024).
  
  
  CONCLUSIONS
  This study supports the use of SELDI-TOF-MS for measuring hepcidin levels in research and clinical applications. Our results in phlebotomized patients suggest that the depletion of iron stores may further exacerbate the HFE-related hepcidin defect.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Verona, Policlinico G.B. Rossi, 37134 Verona, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Bozzini
authors.forename: Natascia
authors.initials: N
authors.lastname: Campostrini
authors.forename: Paola
authors.initials: P
authors.lastname: Trombini
authors.forename: Elizabeta
authors.initials: E
authors.lastname: Nemeth
authors.forename: Annalisa
authors.initials: A
authors.lastname: Castagna
authors.forename: Ilaria
authors.initials: I
authors.lastname: Tenuti
authors.forename: Roberto
authors.initials: R
authors.lastname: Corrocher
authors.forename: Clara
authors.initials: C
authors.lastname: Camaschella
authors.forename: Tomas
authors.initials: T
authors.lastname: Ganz
authors.forename: Oliviero
authors.initials: O
authors.lastname: Olivieri
authors.forename: Alberto
authors.initials: A
authors.lastname: Piperno
authors.forename: Domenico
authors.initials: D
authors.lastname: Girelli
mesh_terms: D000328:Adult; D023181:Antimicrobial Cationic Peptides / Q000652:urine*; D005260:Female; D005293:Ferritins / Q000032:analysis; D006432:Hemochromatosis / Q000175:diagnosis / Q000235:genetics / Q000652:urine*; D000071020:Hemochromatosis Protein; D064451:Hepcidins; D015395:Histocompatibility Antigens Class I / Q000378:metabolism; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism; D008875:Middle Aged; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000379:methods*; D014168:Transferrin / Q000032:analysis
chemical_list: D023181:Antimicrobial Cationic Peptides; C578702:HAMP protein, human; C103673:HFE protein, human; D000071020:Hemochromatosis Protein; D064451:Hepcidins; D015395:Histocompatibility Antigens Class I; D008565:Membrane Proteins; D014168:Transferrin; D005293:Ferritins