Hepcidin in the diagnosis of iron disorders

Abstract

The discovery of the iron-regulatory hormone hepcidin in 2001 has revolutionized our understanding of iron disorders, and its measurement should advance diagnosis/treatment of these conditions. Although several assays have been developed, a gold standard is still lacking, and efforts toward harmonization are ongoing. Nevertheless, promising applications can already be glimpsed, ranging from the use of hepcidin levels for diagnosing iron-refractory iron deficiency anemia to global health applications such as guiding safe iron supplementation in developing countries with high infection burden.

Figure 1

Clinical conditions known to influence circulating hepcidin levels. Clinically relevant conditions include CKD,^, RBC transfusions, iron administration,^. replete iron stores, TMPRSS6 variants,^, infections/inflammatory disorders,^- ineffective erythropoiesis,^, hypoxia,^, administration of erythropoietic stimulating agents, chronic liver diseases, alcohol abuse, HCV, hemochromatosis-related mutations,^,,, and administration of the sex hormones testosterone and estrogens.^, CKD, chronic kidney disease; GFR, glomerular filtration rate; HCV, hepatitis C virus; HH, hereditary hemochromatosis; IDA, iron deficiency anemia; RBC, red blood cell; TMPRSS6 (transmembrane protease serine 6), the gene encoding for matriptase-2.