Ülseratif kolitli hastalarda serum hepsidin düzeyi ölçümünün hastalık aktivasyonunu değerlendirmedeki etkinliği ve güvenirliği

Abstract

Amaç: Çalışmada hepsidin ile inflamasyon markerları ve hastalık şiddeti arasındaki ilişkinin irdelenmesi amaçlanmıştır. Gereç ve yöntem: Bu çalışmada toplam 164 kişi katılmış olup eşit sayıda aktif ve remisyonda olmak üzere 108 Ülseratif Kolit hastası ile 56 kontrol kişisinin hepsidin düzeyleri belirlenmiştir. Elde edilen verilerde hepsidin düzeyleri ile yaş, cinsiyet, ESH, CRP, WBC Hb düzeyleri arasındaki korelasyonlar tespit edilmiş, aktif ÜK hastalarının hepsidin düzeyi ile yaş, cinsiyet, ESH, CRP, WBC, Hb, Truelove-Witts skoru ve Mayo skoru arasındaki ilişki regresyon analizi ile değerlendirilmiştir. Bulgular: Aktif Ülseratif Kolit grubunda ESH, CRP ve Hepsidin düzeyleri remisyon ve kontrol grubuna göre istatistiksel olarak anlamlı düzeyde yüksek; tüm ülseratif kolit grubunda, ESH, CRP, Hepsidin düzeylerinin kontrol grubuna göre istatistiksel açıdan anlamlı düzeyde yüksek saptanmıştır. Ayrıca AÜK grubunda, hepsidin düzeyi ile Truelove Witts skoru ve mayo skoru arasında istatistiksel olarak anlamlı düzeyde pozitif yönde bir korelasyon bulunmuştur (p<0,05) ve ülseratif kolit hastalarında hepsidin düzeyini etki eden faktörleri saptamak için yapılan regresyon analizinde yaş artışının (B=0,143, p<0,05), Truelove Witts Skoru’nun artışının (B=5,224, p<0,001) hepsidin düzeyini arttırdığı; Eritrosit Sedimentasyon Hızının yükselmesinin ise hepsidin düzeyini azalttığı (B=-0,160, p<0,05) tespit edilmiştir. Sonuç: Serum hepsidin düzeyinin yalnızca hastalık aktivasyonunu değil aynı zamanda aktivasyon şiddetinin de değerlendirilmesinde kullanılabilecek bir marker olarak klinik kullanıma girebileceği konusunda umut vadetmektedir.

Keywords

• Ülseratif kolit
• hepsidin
• inflamasyon markerları

Efficiency and reliability of serum hepcidin level measurement in evaluation of disease activation in patients with ulcerative colitis

Abstract

Purpose: The study is to examine the relationship between hepcidin and inflammation markers and disease severity. Materials and methods: Hepcidin levels are determined in 108 Ulcerative Colitis patients and 56 control subjects, a total of 164 subjects, equally active and in remission. Correlations between hepcidin levels and Age, Gender, ESR, CRP, WBC Hb levels are determined in the data. The relationship between hepcidin level of active UC patients and Age, Gender, ESR, CRP, WBC, Hb, Truelove-Witts score and Mayo score is evaluated by regression analysis. Results: ESR, CRP and Hepcidin levels in the Active Ulcerative Colitis group are statistically significantly higher than in the remission and control groups; ESR, CRP, Hepcidin levels are found to be statistically significantly higher in the entire ulcerative colitis group compared to the control group. In addition, a statistically significant positive correlation is found between the hepcidin level and the Truelove Witts score and the Mayo score in the AUC group (p<0.05).In the regression analysis perform to determine the factors affecting hepcidin level in ulcerative colitis patients, increase in Age (B=0.143, p<0.05), increase in Truelove Witts Score (B=5.224, p<0.001) increased Hepcidin level, whereas increase in Erythrocyte Sedimentation Rate decreased hepcidin level (B=-0.160, p<0.05) is determined. Conclusion: It is promising that serum hepcidin level can enter into clinical use as a marker that can be used to evaluate not only disease activation but also the severity of activation.

Keywords

• Ulcerative colitis
• hepcidin
• inflammation markers

References

1. 1. Gajendrana M, Loganathan P, Jimenez G, et al. A comprehensive review and update on ulcerative colitis. 2019;65:100851. https://doi.org/10.1016/j.disamonth.2019.02.004
2. 2. Cho JH. The genetics and immunopathogenesis of inflammatory bowel disease. Nat Rev Immunol 2008;8:458-466. https://doi.org/10.1038/nri2340
3. 3. Pigeon C, Ilyin G, Courselaud B, et al. A new mouse liver-specific gene, encoding a protein homologous to human antimicrobial peptide hepcidin, is overexpressed during iron overload. J Biol Chem 2001;276:7811-7819. https://doi.org/10.1074/jbc.M008923200
4. 4. Nicolas G, Chauvet C, Viatte L, et al. The gene encoding the iron regulatory peptide hepcidin is regulated by anemia, hypoxia, and inflammation. J Clin Invest 2002;110:1037-1044. https://doi.org/10.1172/JCI15686
5. 5. Nemeth E, Valore EV, Territo M, Schiller G, Lichtenstein A, Ganz T. Hepcidin, a putative mediator of anemia of inflammation, is a type II acute-phase protein. Blood 2003;101:2461-2463. https://doi.org/10.1182/blood-2002-10-3235
6. 6. Oustamanolakis P, Koutroubakis IE, Messaritakis I, Malliaraki N, Sfiridaki A, Kouroumalis EA. Serum hepcidin and prohepcidin concentrations in inflammatory bowel disease. Eur J Gastroenterol Hepatol 2011;23:262-268. https://doi.org/10.1097/MEG.0b013e328343b885
7. 7. Nemeth E, Valore EV, Territo M, Schiller G, Lichtenstein A, Ganz T. Hepcidin, a putative mediator of anemia of inflammation, is a type II acute-phase protein. Blood 2003;101:2461-2463. https://doi.org/10.1182/blood-2002-10-3235
8. 8. Ganz T, Olbina G, Girelli D, Nemeth E, Westerman M. Immunoassay for human serum hepcidin. Blood 2008;112:4292-4297. https://doi.org/10.1182/blood-2008-02-139915

9. 9. Jagadish Ramasamy J, Jagadish C, Sukumaran A, et al. Low serum hepcidin levels in patients with ulcerative colitis – ımplications for treatment of co-existent ıron-deficiency anemia. 2023. https://doi.org/10.1007/s10753-023-01887-2
10. 10. Fujita N, Sugimoto R, Takeo M, et al. Hepcidin expression in the liver: relatively low level in patients with chronic hepatitis C. Mol Med 2007;13:97-104. https://doi.org/10.2119/2006-00057.Fujita
11. 11. Malyszko J, Malyszko JS, Pawlak K, Mysliwiec M. Hepcidin, iron status, and renal function in chronic renal failure, kidney transplantation, and hemodialysis. Am J Hematol 2006;81:832-837. https://doi.org/10.1002/ajh.20657
12. 12. Basseri RJ, Nemeth E, Vassilaki ME, et al. Hepcidin is a key mediator of anemia of inflammation in Crohn's disease. J Crohns Colitis 2013;7:286-291.https://doi.org/10.1016/j.crohns.2012.10.013
13. 13. Semrin G, Fishman DS, Bousvaros A, et al. Impaired intestinal iron absorption in Crohn’s disease correlates with disease activity and markers of inflammation. Inflamm Bowel Dis 2006;12:11011106. https://doi.org/10.1097/01.mib.0000235097.86360.04
14. 14. Semrin G, Fishman DS, Bousvaros A, et al. Impaired intestinal iron absorption in Crohn’s disease correlates with disease activity and markers of inflammation. Inflamm Bowel Dis 2006;12:11011106. https://doi.org/10.1097/01.mib.0000235097.86360.04
15. 15. Paköz ZB, Çekiç C, Arabul M, et al. An evalution of the correlation between hepcidin serum levels and disease activity in inflammatory bowel disease. Gastroenterol Res Pract 2015;2015:810942. https://doi.org/10.1155/2015/810942
16. 16. Oustamanolakis P, Koutroubas IE, Messaritakis I, Malliaraki N, Sfiridaki A, Kouroumalis EA. Serum hepcidin and prohepcidin concentrations in inflammatory bowel disease. Eur J Gastroenterol Hepatol 2011;23:262-268. https://doi.org/10.1097/MEG.0b013e328343b885
17. 17. Arnold J, Sangwaiya A, Bhatkal B, Geoghegan F, Busbridge M. Hepcidin and inflammatory bowel disease: dual role in host defence and iron homoeostasis. Eur J Gastroenterol Hepatol 2009;21:425-429. https://doi.org/10.1097/MEG.0b013e32830e2885