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Hepcidin in newly diagnosed inflammatory bowel disease in children
Eva Karaskova1, Jana Volejnikova1, Dusan Holub2
1Department of Pediatrics, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic.
Insights
Children with newly diagnosed Crohn's disease (CD) have higher hepcidin levels than those with ulcerative colitis (UC). Hepcidin levels correlate with disease activity markers, aiding in anemia treatment selection for pediatric inflammatory bowel disease (IBD).
Area of Science:
- Pediatric Gastroenterology
- Hematology
- Immunology
Background:
- Hepcidin is a key regulator of iron homeostasis, influenced by systemic inflammation.
- Inflammatory bowel disease (IBD) encompasses Crohn's disease (CD) and ulcerative colitis (UC), often associated with anemia.
- Understanding hepcidin's role in pediatric IBD is crucial for managing anemia and inflammation.
Purpose of the Study:
- To compare serum hepcidin levels in newly diagnosed pediatric patients with CD versus UC.
- To investigate the association between hepcidin levels and clinical/laboratory markers of IBD activity.
- To explore the implications for anemia management in pediatric IBD.
Main Methods:
- Comparative cross-sectional study of children with newly diagnosed IBD (CD and UC) between 2012 and 2016.
- Analysis of serum hepcidin, C-reactive protein, iron, ferritin, soluble transferrin receptors, blood count, and fecal calprotectin.
- Assessment of disease activity using the Pediatric Crohn's Disease Activity Index and Pediatric Ulcerative Colitis Activity Index.
Main Results:
- Significantly higher serum hepcidin levels were observed in children with CD (22.6 ng/mL) compared to UC (6.5 ng/mL) (P < 0.05).
- Hepcidin showed an independent association with ferritin levels across all IBD patients (P < 0.05).
- Positive correlation between hepcidin and platelet count in CD (P < 0.05); negative correlation with fecal calprotectin in UC (P < 0.05).
Conclusions:
- Distinct hepcidin levels in pediatric CD and UC suggest different contributions of iron deficiency and inflammation to anemia.
- These findings may guide clinicians in selecting optimal anti-anemic treatments for pediatric IBD patients.
- Further research into hepcidin's role can refine therapeutic strategies for anemia in pediatric inflammatory bowel disease.
Aim:
Hepcidin is a central regulator of iron homeostasis. Its production is also influenced by systemic inflammation. The aims of this study were to compare hepcidin levels in paediatric patients newly diagnosed with Crohn's disease (CD) and ulcerative colitis (UC) and to determine the association of hepcidin levels with laboratory and clinical parameters of inflammatory bowel disease (IBD) activity.
Methods:
Children with newly diagnosed IBD between January 2012 and September 2016 were enrolled in this comparative cross-sectional study. We analysed levels of serum hepcidin, C-reactive protein, iron, ferritin, soluble transferrin receptors, blood count and faecal calprotectin in all subjects. Serum hepcidin levels were measured by reverse-phase liquid chromatography. The Paediatric Crohn's Disease Activity Index was used to evaluate CD in children, and Paediatric Ulcerative Colitis Activity Index was used for the assessment of UC disease activity.
Results:
Subjects with CD (n = 53) had significantly higher serum hepcidin levels compared with subjects with UC (n = 23) - 22.6 ng/mL (range 8.5-65.0) versus 6.5 ng/mL (range 2.4-25.8) (P < 0.05). Hepcidin was independently associated with ferritin levels in all IBD patients (P < 0.05). Moreover, there was a significant positive correlation between hepcidin and platelet count (P < 0.05) in children with CD and a negative correlation between hepcidin and faecal calprotectin (P < 0.05) in children with UC.
Conclusion:
Different hepcidin levels between children with newly diagnosed CD and UC suggest the distinct contribution of iron deficiency and/or systemic inflammation to anaemia and may help clinicians choose the best anti-anaemic treatment.
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