Anemia in patients with rheumatoid arthritis
Zeitschrift für Rheumatologie, 08/01/2012
Wahle M – The treatment of rheumatoid arthritis with cytokine antagonists has significant therapeutic implications on anemia in the context of inflammation and impaired iron metabolism.
- The etiology of anemia in RA is complex.
- Anemia of inflammation (AI) and iron deficiency anemia, alone or in combination are the most frequent forms of anemia in RA.
- Changes in iron metabolism are the leading causes of anemia in RA patients and mainly induced by the altered synthesis and function of hepcidin and ferroportin.
- Hepcidin, a peptide produced in the liver and immunocompetent cells, impairs the expression of ferroportin on iron-secreting cells, thus reducing iron bioavailability.
- The typical changes of iron metabolism and hepcidin synthesis in RA are induced by proinflammatory cytokines, primarily interleukin-6.