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Panminerva Medica 2004 September;46(3):165-9

lingua: Inglese

Is hepcidin the bridge linking Helicobacter pylori and anemia of chronic infection? A research proposal

Pellicano R. 1, Rizzetto M. 1,2

1 U.O.A.D.U. Gastro-Hepatology “Molinette” Hospital, Turin, Italy
2 Unit of Gastroenterology Department of Internal Medicine University of Turin, Turin, Italy


Since the ­last ­decade, sev­er­al stud­ies ­have report­ed on the ­link ­between chron­ic Helicobacter pylo­ri (H. pylo­ri) or Helicobacter spe­cies (H. spe­cies) infec­tion and a varie­ty of extra­gas­tric man­i­fes­ta­tions, com­pris­ing ­iron-defi­cien­cy ane­mia. A cru­cial ques­tion con­cerns ­which pos­sible path­o­gen­ic mech­a­nism of H. pylo­ri infec­tion may be ­involved in chron­ic ane­mia. Recent find­ings sup­port the hypoth­e­sis ­that in sub­jects ­with H. pylo­ri-pos­i­tive gas­tritis, con­com­i­tant chang­es in intra­gas­tric pH and ascor­bic ­acid are ­present ­that ­might ­play a ­role in impair­ing ali­men­tary ­iron absorp­tion ­with con­se­quent side­ro­pen­ic ane­mia. It has ­also ­been spec­u­lat­ed ­that H. pylo­ri infect­ed ­antrum ­could act as a seques­ter­ing ­focus for ­iron. The bac­te­ri­um enhanc­es gas­tric lac­to­fer­rin, ­which cap­tures ­iron ­from trans­fer­rin. The ­iron ­thus ­bound to lac­to­fer­rin is in ­turn ­picked up by the bac­te­ri­um, by ­means of its out­er mem­brane recep­tors, for its own ­growth. These mod­els, how­ev­er, are not ­able to ­answer why ­iron-defi­cien­cy ane­mia ­does not devel­op in all infect­ed sub­jects. Recently, a new ­anti-micro­bi­al liv­er-­made pep­tide, name­ly hep­ci­din, has ­been char­ac­ter­ised. The ­link ­between hep­ci­din induc­tion, inflam­ma­tion and ane­mia ­both in ­humans and in ani­mal mod­els sup­ports its key ­role as medi­a­tor of ane­mia of inflam­ma­tion. In the ­present ­paper, we high­light the ­data avail­able on the asso­ci­a­tion ­between H. pylo­ri and ­iron-defi­cien­cy ane­mia and, we pro­pose to eval­u­ate a pos­sible mech­a­nism involv­ing hep­ci­din in a bridg­ing ­role link­ing the infec­tion to the ane­mia.

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