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.

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