1/ #UncleBob is working to better understand hepcidin. Please critique this so that we can have a better understanding.
Hepcidin is a peptide hormone. Its main function is the regulator of iron entry into the circulation
Hepcidin is a peptide hormone. Its main function is the regulator of iron entry into the circulation
2/ As hepcidin levels increase, iron transport into the circulation decreases. It does this by binding to ferroportin - the transport channel.
Thus - decreased dietary iron absorption. It also leads to iron sequestration in macrophages.
Thus - decreased dietary iron absorption. It also leads to iron sequestration in macrophages.
3/ Why should we care? IL-6 (a proinflammatory cytokine) stimulates hepcidin. Thus the anemia of chronic inflammation results from increased hepcidin which in turn makes iron less available to the bone marrow.
4/ When we ingest iron, we also stimulate hepcidin - thus taking too much oral iron has the paradoxical effect of decrease iron absorption and iron access. This likely explains the newer concept of once daily or every other day oral iron.
5/ We can overcome some of hepcidin's absorption problems with IV iron. I suspect this is why many CKD 4&5 patients get anemia improvement with IV iron (and do not always need EPO.
6/ In working on this tweetorial I did much extra reading to better understand this important hormone. I'm certain that I have more to learn. Please teach me.
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