Hepcidin as a therapeutic target for anemia and inflammation associated with chronic kidney disease

Area of Science:

• Nephrology
• Hematology
• Pharmacology

Background:

• Anemia is a frequent complication of chronic kidney disease (CKD), stemming from complex multifactorial causes.
• Recent advancements in understanding iron metabolism, particularly the discovery of hepcidin, have opened new therapeutic avenues.
• The hepcidin-ferroportin pathway is central to iron regulation and a key target for managing anemia.

Purpose of the Study:

• To review the role of hepcidin in iron metabolism and regulation within the context of CKD.
• To explore emerging therapeutic strategies targeting hepcidin and the hepcidin-ferroportin axis for renal anemia.
• To discuss novel drug candidates and their potential impact on managing anemia.

Main Methods:

• Literature review focusing on hepcidin's role in iron metabolism and CKD-associated anemia.
• Analysis of therapeutic targets including anti-hepcidin antibodies, spigelmers, and anticalins.
• Examination of compounds affecting the bone morphogenetic protein receptor (BMP/BMPR) complex and hypoxia-inducible factor 1 (HIF-1) stabilizers.

Main Results:

• Hepcidin is identified as a critical regulator of iron availability.
• Therapeutic targeting of hepcidin and the hepcidin-ferroportin axis shows significant potential for treating renal anemia.
• Novel agents like anti-hepcidin antibodies and HIF-1 stabilizers are emerging as promising interventions.

Conclusions:

• Hepcidin represents a key therapeutic target for managing anemia in CKD patients.
• While novel therapies show promise, clinical data are still limited, necessitating further development.
• Inhibiting hepcidin through various mechanisms may offer a viable adjunctive treatment option for anemia in diverse clinical settings.