title: Increased hepcidin expression in multibacillary leprosy.
abstract: Iron is essential for all organisms and its availability can control the growth of microorganisms; therefore, we examined the role of iron metabolism in multibacillary (MB) leprosy, focusing on the involvement of hepcidin. Erythrograms, iron metabolism parameters, pro-inflammatory cytokines and urinary hepcidin levels were evaluated in patients with MB and matched control subjects. Hepcidin expression in MB lesions was evaluated by quantitative polymerase chain reaction. The expression of ferroportin and hepcidin was evaluated by immunofluorescence in paucibacillary and MB lesions. Analysis of hepcidin protein levels in urine and of hepcidin mRNA and protein levels in leprosy lesions and skin biopsies from healthy control subjects showed elevated hepcidin levels in MB patients. Decreases in haematologic parameters and total iron binding capacity were observed in patients with MB leprosy. Moreover, interleukin-1 beta, ferritin, soluble transferrin receptor and soluble transferrin receptor/log ferritin index values were increased in leprosy patients. Hepcidin was elevated in lepromatous lesions, whereas ferroportin was more abundant in tuberculoid lesions. In addition, hepcidin and ferroportin were not colocalised in the biopsies from leprosy lesions. Anaemia was not commonly observed in patients with MB; however, the observed changes in haematologic parameters indicating altered iron metabolism appeared to result from a mixture of anaemia of inflammation and iron deficiency. Thus, iron sequestration inside host cells might play a role in leprosy by providing an optimal environment for the bacillus.
authors.affiliation: Instituto Lauro de Souza Lima, Secretaria de Estado da Saúde, Bauru, SP, Brasil.
authors.forename: Vânia Nieto Brito de
authors.initials: VN
authors.lastname: Souza
authors.forename: Tatiana Salles de Souza
authors.initials: TS
authors.lastname: Malaspina
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Campanelli
authors.forename: Cássio
authors.initials: C
authors.lastname: Ghidella
authors.forename: Somei
authors.initials: S
authors.lastname: Ura
authors.forename: Dirceu
authors.initials: D
authors.lastname: Dalpino
authors.forename: Dejair Caitano
authors.initials: DC
authors.lastname: do Nascimento
authors.forename: Ana Carla Pereira
authors.initials: AC
authors.lastname: Latini
mesh_terms: D000740:Anemia / Q000382:microbiology; D023181:Antimicrobial Cationic Peptides / Q000652:urine*; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood*; D018450:Disease Progression; D005455:Fluorescent Antibody Technique; D064451:Hepcidins; D006705:Homeopathy; D006801:Humans; D007249:Inflammation / Q000382:microbiology; D007501:Iron / Q000378:metabolism*; D056006:Leprosy, Multibacillary / Q000097:blood* / Q000150:complications / Q000652:urine*; D016133:Polymerase Chain Reaction
chemical_list: D023181:Antimicrobial Cationic Peptides; D016207:Cytokines; C578702:HAMP protein, human; D064451:Hepcidins; D007501:Iron