title: Serum hepcidin and growth differentiation factor-15 (GDF-15) levels in polycythemia vera and essential thrombocythemia.
abstract: OBJECTIVE
  Hepcidin plays a regulatory role in systemic iron homeostasis. GDF-15 has been found to be expressed from matured erythroblasts and very high levels of GDF-15 suppresses hepcidin secretion. In this study, we evaluated hepcidin and GDF-15 levels in polycythemia vera (PV) and essential thrombocythemia (ET).
  
  
  METHODS
  The study included 29 patients and 21 healthy controls. The patient group included 13 patients with ET and 16 patients with PV. Serum hepcidin and GDF-15 levels were measured at the time of diagnosis, before the initiation of any therapy.
  
  
  RESULTS
  Hepcidin levels did not differ significantly in patients with chronic myeloproliferative disease (CMPD) and healthy controls. However, GDF-15 levels were significantly increased in patients with CMPD (P = 0.038). No difference could be found between patients with PV and ET in terms of hepcidin and GDF-15 levels. Patients with JAK2-V617F mutation had increased GDF-15 levels when compared with patients without this mutation (P: 0.006).
  
  
  CONCLUSIONS
  The levels of GDF-15 were higher in CMPD, which are characterized by increased erythropoiesis, and this effect was more pronounced particularly in individuals with JAK2-V617F mutation. Hepcidin levels were not suppressed despite the increased erythroid activity and GDF-15 levels may be protective against the clinical complications of the disease such as thrombosis. This study revealed that, hepcidin levels were not suppressed despite increased erythroid activity and high GDF-15 levels in CMPD. We hypothesized that, this may be an attempt to prevent further amplification of erythropoietic activity by reducing iron utilization.
authors.affiliation: Department of Hematology, Medical Faculty, Kocaeli University, Kocaeli, Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Tarkun
authors.affiliation: Department of Hematology, Medical Faculty, Kocaeli University, Kocaeli, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Mehtap
authors.affiliation: Department of Hematology, Medical Faculty, Kocaeli University, Kocaeli, Turkey.
authors.forename: Elif B
authors.initials: EB
authors.lastname: Atesoğlu
authors.affiliation: Department of Hematology, Medical Faculty, Kocaeli University, Kocaeli, Turkey.
authors.forename: Ayfer
authors.initials: A
authors.lastname: Geduk
authors.affiliation: Department of Medical Biochemistry, Medical Faculty, Kocaeli University, Kocaeli, Turkey.
authors.forename: Mahmut M
authors.initials: MM
authors.lastname: Musul
authors.affiliation: Department of Hematology, Medical Faculty, Kocaeli University, Kocaeli, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Hacihanefioglu
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D055436:Growth Differentiation Factor 15 / Q000097:blood*; D064451:Hepcidins / Q000097:blood*; D006801:Humans; D053614:Janus Kinase 2 / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011087:Polycythemia Vera / Q000097:blood* / Q000235:genetics; D013920:Thrombocythemia, Essential / Q000097:blood* / Q000235:genetics
chemical_list: D055436:Growth Differentiation Factor 15; D064451:Hepcidins; D053614:Janus Kinase 2
keywords: essential thrombocythemia; growth differentiation factor-15; hepcidin; polycythemia vera