title: Expression of the iron hormone hepcidin distinguishes different types of anemia in African children.
abstract: Childhood anemia is a major global health problem resulting from multiple causes. Iron supplementation addresses iron deficiency anemia but is undesirable for other types of anemia and may exacerbate infections. The peptide hormone hepcidin governs iron absorption; hepcidin transcription is mediated by iron, inflammation, and erythropoietic signals. However, the behavior of hepcidin in populations where anemia is prevalent is not well established. We show that hepcidin measurements in 1313 African children from The Gambia and Tanzania (samples taken in 2001 and 2008, respectively) could be used to identify iron deficiency anemia. A retrospective secondary analysis of published data from 25 Gambian children with either postmalarial or nonmalarial anemia demonstrated that hepcidin measurements identified individuals who incorporated >20% oral iron into their erythrocytes. Modeling showed that this sensitivity of hepcidin expression at the population level could potentially enable simple groupings of individuals with anemia into iron-responsive and non-iron-responsive subtypes and hence could guide iron supplementation for those who would most benefit.
authors.affiliation: Medical Research Council (MRC) Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DS, UK.
authors.forename: Sant-Rayn
authors.initials: SR
authors.lastname: Pasricha
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Atkinson
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Armitage
authors.forename: Shivani
authors.initials: S
authors.lastname: Khandwala
authors.forename: Jacobien
authors.initials: J
authors.lastname: Veenemans
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Cox
authors.forename: Lucy A
authors.initials: LA
authors.lastname: Eddowes
authors.forename: Theodore
authors.initials: T
authors.lastname: Hayes
authors.forename: Conor P
authors.initials: CP
authors.lastname: Doherty
authors.forename: Ayse Y
authors.initials: AY
authors.lastname: Demir
authors.forename: Edwin
authors.initials: E
authors.lastname: Tijhaar
authors.forename: Hans
authors.initials: H
authors.lastname: Verhoef
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Prentice
authors.forename: Hal
authors.initials: H
authors.lastname: Drakesmith
mesh_terms: D000349:Africa; D000740:Anemia / Q000145:classification* / Q000175:diagnosis / Q000378:metabolism; D002648:Child; D004912:Erythrocytes / Q000378:metabolism; D064451:Hepcidins / Q000378:metabolism*; D006801:Humans; D007501:Iron / Q000378:metabolism*; D012189:Retrospective Studies
chemical_list: D064451:Hepcidins; D007501:Iron