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Respiratory infections drive hepcidin-mediated blockade of iron absorption leading to iron deficiency anemia in African children


Prentice, AM; Bah, A; Jallow, MW; Jallow, AT; Sanyang, S; Sise, EA; Ceesay, K; Danso, E; Armitage, AE; Pasricha, SR; Drakesmith, H; Wathuo, M; Kessler, N; Cerami, C; Wegmuller, R
2019-03
Scientific Advances
Journal Article
5
3
eaav9020
Iron deficiency anemia (IDA) is the most prevalent nutritional condition worldwide. We studied the contribution of hepcidin-mediated iron blockade to IDA in African children. We measured hepcidin and hemoglobin weekly, and hematological, inflammatory, and iron biomarkers at baseline, 7 weeks, and 12 weeks in 407 anemic (hemoglobin < 11 g/dl), otherwise healthy Gambian children (6 to 27 months). Each child maintained remarkably constant hepcidin levels (P < 0.0001 for between-child variance), with half consistently maintaining levels that indicate physiological blockade of iron absorption. Hepcidin was strongly predicted by nurse-ascribed adverse events with dominant signals from respiratory infections and fevers (all P < 0.0001). Diarrhea and fecal calprotectin were not associated with hepcidin. In multivariate analysis, C-reactive protein was the dominant predictor of hepcidin and contributed to iron blockade even at very low levels. We conclude that even low-grade inflammation, especially associated with respiratory infections, contributes to IDA in African children.
AAAS
Population Health and Immunity
10.1126/sciadv.aav9020
30944864
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Creation Date 2019-04-11 12:23:46 Last Modified 2019-04-11 01:37:34