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Journal of Clinical Immunology

, Volume 32, Issue 4, pp 746–752 | Cite as

Inflammation-Induced Hepcidin is Associated with the Development of Anemia and Coronary Artery Lesions in Kawasaki Disease

  • Ho-Chang Kuo
  • Ya-Ling Yang
  • Jiin-Haur Chuang
  • Mao-Meng Tiao
  • Hong-Ren Yu
  • Li-Tung Huang
  • Kuender D. Yang
  • Wei-Chiao Chang
  • Chiu-Ping Lee
  • Ying-Hsien Huang
Article

Abstract

Purpose

Kawasaki disease (KD) is a systemic febrile vasculitis complicated by coronary artery lesions (CAL). Anemia is common in patients with KD and is associated with a prolonged duration of active inflammation. Hepcidin is a central modulator of inflammation-associated anemia, acting via control of iron absorption and a direct inhibitory effect on erythropoiesis. The aims of this study were to investigate the role of inflammation-induced hepcidin in the development of anemia, the occurrence of CAL formation, and IVIG treatment response in patients with KD.

Methods

Eighty-six KD patients and 30 febrile controls were enrolled. Levels of interleukin (IL)-6 and serum hepcidin were measured in sera by enzyme-linked immunosorbent assay. Hemoglobin and serum iron levels were also measured.

Results

Hemoglobin and iron levels were lower in KD patients than in controls (p < 0.001 and p = 0.009, respectively). Serum hepcidin and IL-6 levels were higher in KD patients than in controls (both p < 0.001) before intravenous immunoglobulin (IVIG) treatment. After IVIG treatment, serum hepcidin, IL-6, and hemoglobin levels decreased significantly (all p < 0.001). In addition, the serum hepcidin levels before IVIG treatment were negatively correlated with hemoglobin levels after IVIG treatment (R = −0.188, p = 0.046) and positively correlated with the changes of hemoglobin levels after IVIG treatment (R = 0.269, p = 0.015). Furthermore, serum hepcidin levels were negatively correlated with serum iron levels (R = −0.412, p = 0.002), which were positively correlated with hemoglobin levels (R = 0.210, p = 0.045). Additionally, the change of hepcidin levels was associated with IVIG treatment response and the occurrence of CAL formation.

Conclusions

Inappropriately raised hepcidin levels impair iron metabolism and are associated with decreased hemoglobin levels in KD patients. Inflammation-induced hepcidin is associated with the development of anemia and disease outcomes in patients with KD.

Keywords

Coronary artery lesion hemoglobin hepcidin IL-6 iron Kawasaki disease 

Notes

Acknowledgments

This study was supported by grants from the National Science Council Grant #NSC 99-2314-B-182A-032-MY2, NSC 100-2314-B-182A-048-MY3, and Chang Gung Memorial Hospital CMRPG8A021, Taiwan.

Conflicts of Interest

The authors have indicated that they have no financial relationships relevant to this article to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Ho-Chang Kuo
    • 1
  • Ya-Ling Yang
    • 3
  • Jiin-Haur Chuang
    • 4
  • Mao-Meng Tiao
    • 2
  • Hong-Ren Yu
    • 2
  • Li-Tung Huang
    • 2
  • Kuender D. Yang
    • 5
  • Wei-Chiao Chang
    • 6
  • Chiu-Ping Lee
    • 2
  • Ying-Hsien Huang
    • 2
  1. 1.Genomic and Proteomic Core Laboratory, Department of Medical Research and Department of PediatricsKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiungRepublic of China
  2. 2.Department of PediatricsKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiungRepublic of China
  3. 3.Department of AnesthesiologyKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiungRepublic of China
  4. 4.Department of SurgeryKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiungRepublic of China
  5. 5.Department of Medical ResearchShow Chwan Memorial Hospital in Chang BingChanghuaRepublic of China
  6. 6.Department of Medical Genetics, Kaohsiung Medical UniversityCancer Center, Kaohsiung Medical University HospitalKaohsiungRepublic of China

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