Related Experiment Video
Updated: Nov 21, 2025

Mouse Fetal Liver Culture System to Dissect Target Gene Functions at the Early and Late Stages of Terminal Erythropoiesis
Published on: September 9, 2014
Is the erythropoietin-erythroferrone-hepcidin axis intact in human neonates?
Timothy M Bahr1, Diane M Ward2, Xuan Jia3
1Division of Neonatology, University of Utah Health, Salt Lake City, UT, USA.
Insights
The newborn iron regulation pathway involving erythropoietin (Epo), erythroferrone (ERFE), and hepcidin is functional. This pathway remains intact in neonates, even those born preterm or to mothers with diabetes and obesity.
Area of Science:
- Neonatal physiology
- Endocrinology
- Hematology
Background:
- Iron homeostasis is crucial for neonatal development.
- The erythropoietin (Epo)/erythroferrone (ERFE)/hepcidin axis is a key regulator of iron metabolism.
- Understanding this axis in neonates is essential for managing iron status.
Purpose of the Study:
- To assess the Epo/ERFE/hepcidin pathway in human neonates.
- To compare iron-related metrics in term, preterm, and neonates born to mothers with diabetes/obesity.
- To evaluate the pathway's response to darbepoetin administration.
Main Methods:
- Quantified Epo, ERFE, hepcidin, ferritin, and RET-He in umbilical cord blood.
- Analyzed samples from term (n=13), preterm (n=10), and neonates of mothers with diabetes/obesity (n=13).
- Measured serum Epo, ERFE, and hepcidin before and after darbepoetin administration.
Main Results:
- Epo and ERFE levels did not differ significantly across groups.
- Preterm neonates showed the lowest hepcidin levels.
- Neonates born to mothers with diabetes/obesity had lower ferritin and RET-He.
- Darbepoetin increased ERFE and decreased hepcidin levels (p < 0.05).
Conclusions:
- The Epo/ERFE/hepcidin hormonal pathway is intact in the newborn period.
- This axis appears functional in neonates, regardless of gestational age or maternal health conditions.
- The findings support the role of this pathway in neonatal iron regulation.
Abstract:
In a two-part process, we assessed elements of the principal hormonal pathway regulating iron homeostasis in human neonates. Part 1: Quantifying erythropoietin (Epo), erythroferrone (ERFE), hepcidin, and relevant serum and erythrocytic iron-related metrics in umbilical cord blood from term (n = 13) and preterm (n = 10) neonates, and from neonates born to mothers with diabetes and obesity (n = 13); Part 2: Quantifying serum Epo, ERFE, and hepcidin before and following darbepoetin administration. Part 1: We measured Epo, ERFE and hepcidin in all cord blood samples. Epo and ERFE levels did not differ between the three groups. Preterm neonates had the lowest hepcidin levels, while neonates born to diabetic women with a very high BMI had the lowest ferritin and RET-He levels. Part 2: Following darbepoetin dosing, ERFE levels generally increased (p < 0.05) and hepcidin levels generally fell (p < 0.05). Our observations suggest that the Epo/ERFE/hepcidin axis is intact in the newborn period.
Related Concept Videos
Erythropoiesis
Lifecycle of Erythrocytes
The resident phagocytic macrophages deal with these damaged cells by engulfing them and separating their globin and heme groups....
Factors Affecting Erythropoiesis
Several factors influence the erythrocyte production rate, with tissue oxygen level being among the most critical. Intense exercise or high altitudes can cause tissue hypoxia, which triggers the kidneys to release more erythropoietin (EPO) into the bloodstream.
EPO then...
Role of Hematopoietic Growth Factors
Thrombopoietin (TPO), mainly released by the liver,...
The Early Endosome: Endocytosis of Transferrin
Rh Blood Group

