Научно-практическая ревматология (Nov 2022)
Pathophysiology of iron and hepcidin metabolism: research perspectives in rheumatolog
Abstract
Despite advances in the study of iron metabolism, anemia of chronic inflammation (AI) and iron deficiency remain major global health problems. In immunoinflammatory rheumatic diseases (RD), the most common variants are iron deficiency anemia (IDA) as the most common type of anemia, and AI, which itself can aggravate the course of the underlying disease due to tissue iron overload, additional activation and maintenance of inflammation activity. In recent years, the diagnostic and therapeutic role of hepcidin as a key regulator of iron metabolism has been widely discussed.The study of the ways of regulation and synthesis of hepcidin in immuno-inflammatory RD may be of great importance for identifying the pathogenetic mechanisms underlying the formation of resistance to therapy, as well as for the appearance of severe concomitant pathology in patients that makes it difficult to prescribe adequate therapy. The most interesting from the perspective of further study are the interleukin 6 – JAK2 – STAT3 axis and chronic hypoxia, which occurs in such chronic conditions as cardiovascular pathology, chronic kidney disease, interstitial lung damage, etc.
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