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Changes in serum hepcidin levels in children with inflammatory bowel disease during anti-inflammatory treatment
Eva Karaskova1, Jana Volejnikova1, Dusan Holub2
1Department of Pediatrics, Faculty of Medicine and Dentistry, University Hospital Olomouc, Palacky University Olomouc, Olomouc, Czech Republic.
Insights
Serum hepcidin levels were higher in children with Crohn's disease (CD) than ulcerative colitis (UC) at diagnosis. Therapy significantly reduced hepcidin in CD patients, while levels remained low in UC patients.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Hematology
Background:
- Inflammatory bowel disease (IBD) encompasses Crohn's disease (CD) and ulcerative colitis (UC), affecting children.
- Hepcidin, a key regulator of iron metabolism, plays a role in inflammation and IBD.
- Understanding hepcidin dynamics during IBD treatment is crucial for managing iron status and disease activity.
Purpose of the Study:
- To compare serum hepcidin level changes in pediatric IBD patients undergoing therapy.
- To correlate hepcidin changes with iron metabolism, inflammation markers, and treatment type.
- To investigate differences in hepcidin profiles between CD and UC in children.
Main Methods:
- A longitudinal study included newly diagnosed pediatric patients with CD (n=30) and UC (n=13).
- Serum hepcidin, iron metabolism markers, and inflammation parameters were measured at baseline and during maintenance therapy (mean follow-up 39 months).
- Statistical analyses compared hepcidin levels and correlated them with clinical and laboratory parameters.
Main Results:
- Pediatric CD patients exhibited higher baseline serum hepcidin levels than UC patients.
- Serum hepcidin significantly decreased in CD patients during therapy (36.5 to 2.1 ng/mL), but remained stable in UC patients (5.4 vs. 4.8 ng/mL).
- Hepcidin changes correlated with disease activity and inflammatory markers (ESR, CRP) in CD, and with serum iron in UC. Biological therapy showed greater reduction in CRP and IL-6 than conventional therapy in CD.
Conclusions:
- Children with CD present with higher serum hepcidin levels at diagnosis compared to those with UC.
- Anti-inflammatory therapy leads to a significant decrease in serum hepcidin in pediatric CD patients.
- Serum hepcidin levels remain consistently low in pediatric UC patients during treatment.
Aim:
The aim of this study was to compare changes in serum hepcidin levels in paediatric patients with inflammatory bowel disease during therapy and correlate them with markers of iron metabolism, inflammation and type of treatment.
Methods:
Children with newly diagnosed Crohn's disease (CD) and ulcerative colitis (UC) were included in this longitudinal study. Blood and stool samples were collected to assess levels of serum hepcidin and markers of iron metabolism parameters and inflammation. The parameters were examined before treatment (baseline levels) and compared with levels in the follow-up period during maintenance therapy (mean follow-up of 39 months after diagnosis).
Results:
Patients with CD (n = 30) had higher serum hepcidin levels (expressed as a median and interquartile range) at diagnosis than subjects with UC (n = 13). These levels significantly decreased during the follow-up (from 36.5 (11.5-79.6) to 2.1 (0.9-6.7) ng/mL). In contrast, no significant serum hepcidin level changes were observed in the UC patients (5.4 (3.4-16.6) vs. 4.8 (0.9-8.1) ng/mL). While hepcidin level changes correlated with disease activity and inflammatory parameters (erythrocyte sedimentation rate, C-reactive protein), in CD patients, they correlated only with serum iron levels in patients with UC. Biological therapy was accompanied by a significant decrease in C-reactive protein and interleukin-6 compared to conventional anti-inflammatory therapy in CD patients.
Conclusions:
Children with CD had higher serum hepcidin levels on diagnosis compared to subjects with UC. During an anti-inflammatory therapy, serum hepcidin decreased in the CD group but remained consistently low in children with UC.
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