The effect of nonsurgical periodontal therapy on hepcidin and on inflammatory and iron marker levels

Abstract Serum hepcidin levels may increase in response to infection and inflammation. The present study investigated the effect of nonsurgical periodontal therapy (NSPT) on levels of serum hepcidin, inflammatory markers, and iron markers. An interventional study was conducted on 67 patients (age 30-65 years) without other diseases, except for chronic periodontitis (CP). Patients were allocated to either CP or control groups. The CP group received supragingival and subgingival scaling and root planing procedures, whereas the control group received supragingival scaling. Probing depth (PD), bleeding on probing, clinical attachment level (CAL), visible plaque index (VPI), serum hepcidin and interleukin-6 (IL-6) levels, high-sensitivity C-reactive protein (hs-CRP), hematological markers, and iron markers were measured at baseline and at 90 days after NSPT. The CP group had statistically significant lower mean values for mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) (p ≤ 0.05). The control group had statistically significant reductions in hemoglobin, hematocrit, MCV, and MCH (p ≤ 0.05). Serum hepcidin, IL-6, and erythrocyte sedimentation rate (ESR) levels were significantly decreased in both groups after NSPT. Periodontal markers were more markedly reduced in the CP group compared with the control group (p ≤ 0.05). These findings suggest that NSPT may reduce the serum levels of IL-6, hepcidin, and periodontal parameters.

Hepcidin serum levels in HCV chronically mono-infected naïve patients, compared to healthy individuals

Introduction: Metabolism of iron is altered in patients infected with chronically Hepatitis C. The aim of this study is to compare compare the hepcidin levels in between individuais chronically infected with HCV and uninfected individuals. The aim of this study is to compare the hepcidin serum levels between individuals chronically infected with HCV and uninfected individuals. Methods: A cross-sectional study evaluating hepcidin serum levels of mono-infected HCV (n=29), naive, non-diabetic, non-cirrhotic and non-obese patients by means of ELISA, compared to uninfected patients (n=9) with the same characteristics. The degree of liver fibrosis, according to the METAVIR scale on liver biopsies, the lipid profile, the resistance insulin level, as calculated on HOMA-IR (homeostatic model assessment for insulin resistance), the interleukin-6 (IL-6) and the ferritin serum levels were also measured. Results: The levels of hepcidin were significantly lower in HCV patients compared to controls (8.4 pg/mL (±4.94) vs. 19.51 pg/mL (±5.51)) with p<0.001. The levels of ferritin and hepcidin did not show any relation. There was no difference between hepcidin levels in relation to viral genotype, viral load, IL-6 and degrees of fibrosis within HCV infected individuals. Conclusion: It is possible that hepatic iron overload in this population is explained by suppressed levels of hepcidin in patients with HCV. (AU)

Serum hepcidin level and disease course of acute leukemia in children

Acute leukemia [AL] is a heterogeneous group of hematopoietic neoplasms and it is the most common childhood malignancy. Many patients with AL develop severe anemia that requires multiple blood transfusions. Hepcidin expression may play a role in anemia which is often seen in these patients. The aim of this study is to evaluate the role of hepcidin in acute lymphoblastic leukemia in children in Egypt. 60 patients with acute lymphoblastic leukemia [ALL] and 20 age and gender matched healthy children, taken as control group, were included in the study. Complete blood count [CBC], Serum ALT and serum AST were measured by colorimetric methods. Serum hepcidin and ferritin were measured by ELISA. The study showed a significant difference between newly diagnosed ALL cases and other groups regarding all CBC parameters. There was a significant difference in serum levels of hepcidin and ferritin between studied groups. A significant negative correlation was found between serum level of hepcidin and ferritin and each of hemoglobin level and reticulocytic count%, while significant positive correlation was found between hepcidin and ferritin serum levels. From this study, it could be concluded that serum hepcidin level is elevated in ALL children patients at time of diagnosis and correlates with the disease extent. Hepcidin may be one of the serum markers that accounting for anemia associated with ALL in children

Anemia de las enfermedades crónicas asociada a obesidad: papel de la hepcidina como mediador central / Hepcidin as a central mediator of anemia of chronic diseases associated with obesity

Recent evidence suggests that obesity-related inflammation may play a central role in hepcidin regulation. Hepcidin is a key regulator ofiron homeostasis and has now been suggested as a central mediator ofiron metabolism disorders involved in the pathogenesis of anemia of chronic disease. In this review, we focus on subclinical inflammation in obesity and its effect on hepcidin levels, as the most plausible explanation for the relationship between anemia of chronic disease and obesity.

key regulator for iron homeostasis in chronic hepatitis C

Hepcidin is a small, cysteine-rich cationic peptide produced by hepatocytes. There is a single human hepcidin gene; whose essential role in iron homeostasis was confirmed by identifying homozygous frameshift or nonsense mutations in affected individuals with severe Juvenile hemochromatosis. IL-6 may be the mediator of hepcidin induction by inflammation. Hypoferremia is a common response to systemic infections or generalized inflammatory disorders, anemia of chronic disease occurs in patients with acute and chronic immune activation and represents an important clinical problem. The study will attempt to determine the hepatic hepcidin expression levels in patients with chronic hepatitis C virus infection. Fifty patients with chronic hepatitis C virus infection [CHCV], their age between [20- 55] years, selected from the National Hepatology and Tropical Medicine Research Institute were included in this study, before interferon and Ribavirin therapy, and ten healthy individuals were included to serve as controls. All the patients and controls were subjected to the following history, clinical examination, abdominal ultrasonography and collection of blood samples for routine laboratory investigations. CBCs and serological assay for serum ferritin, iron, transferrin [s-TFR] levels, Liver biopsy for hepcidin mRNA levels and iron deposits in liver by [PCR] polymerase chain reaction. All subjects gave written informed consent for enrolment in the study, which was approved by the Research Ethical Committee of the General Organization for Teaching Hospitals and Institutes. Liver biopsy was taken from healthy subjects during abdominal surgery. Our results revealed that hepatic hepcidin expression is considered highly valid marker in case of CHCV infection. Our study concluded that there's a highly significant inverse correlation between hepcidin versus liver iron, serum iron and serum transferrin but there's no significant correlation versus ferritin. Hepcidin measuring and manipulating hepcidin levels will, in the future, have a role in diagnosing and treating any number of iron related disorders. Hepcidin itself has antimicrobial properties of uncertain importance so that careful clinical trials will be required to define appropriate indications of hepcidin antagonists