Anemia of inflammation: the cytokine-hepcidin link

Abstract

The anemia of inflammation, commonly observed in patients with chronic infections, malignancy, trauma, and inflammatory disorders, is a well-known clinical entity. Until recently, we understood little about its pathogenesis. It now appears that the inflammatory cytokine IL-6 induces production of hepcidin, an iron-regulatory hormone that may be responsible for most or all of the features of this disorder.

Figure 1

Regulation of hepcidin production in inflammation. Inflammation leads to macrophage elaboration of IL-6, which acts on hepatocytes to induce hepcidin production. Hepcidin inhibits macrophage iron release and intestinal iron absorption, leading to hypoferremia.