Skip to main content
SpringerLink
Log in

Surgical Inflammation Induces Hepcidin Production after Abdominal Surgery

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Hepcidin, a key regulator of iron homeostasis, is also a marker of acute inflammation. In the present study we investigated the changes in the serum hepcidin level and correlations between hepcidin and other markers of acute inflammation during the perioperative period in patients after abdominal surgery.

Methods

Serum hepcidin, hemoglobin (Hb), hematocrit (Ht), white blood cell (WBC) count, frequency of neutrophils, and C-reactive protein (CRP) were measured preoperatively (Pre), and on postoperative days (POD) 1, 3, 7, and 14.

Results

In patients undergoing gastrectomy, the median levels of hepcidin preoperatively and on POD 1, 3, 7, and 14 were 6.5, 53.1, 31.7, 15.6, and 4.0 ng/dl, respectively (p < 0.0001). The corresponding levels in colectomy patients were 8.5, 78.3, 60.1, 49.7, and 8.4 ng/dl, respectively (p = 0.0002); those in hepatectomy patients were 6.6, 16.3, 3.5, 13.4, and 3.4 ng/dl, respectively (p = 0.0022); and those in patients undergoing surgery for diffuse peritonitis were 24.8, 50.1, 43.1, 31.2, and 31.7 ng/dl, respectively (p = 0.4933). There were no significant decreases in Hb and Ht in the patients undergoing gastrectomy, colectomy, or surgery for diffuse peritonitis. The level of hepcidin was significantly correlated with the WBC count, frequency of neutrophils, and CRP level during the perioperative period for all four types of operation.

Conclusions

Like other inflammatory markers, an increase in the level of hepcidin (i.e., a hepcidin storm) occurs in the acute phase after gastrectomy, colectomy, hepatectomy, and surgery for diffuse peritonitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Park CH, Valore EV, Waring AJ et al (2001) Hepcidin, a urinary antimicrobial peptide synthesized in the liver. J Biol Chem 276:7806–7810

    Article  PubMed  CAS  Google Scholar 

  2. Nemeth E, Valore EV, Territo M et al (2003) Hepcidin, a putative mediator of anemia of inflammation, is a type II acute-phase protein. Blood 101:2363–2461

    Article  Google Scholar 

  3. Ganz T, Olbina D, Nemeth E et al (2008) Immunoassay for human serum hepcidin. Blood 112:4292–4297

    Article  PubMed  CAS  Google Scholar 

  4. Ganz T, Nemeth E (2009) Iron sequestration and anemia of inflammation. Semin Hematol 46:387–393

    Article  PubMed  CAS  Google Scholar 

  5. Cartwright GE (1966) The anemia of chronic disorders. Semin Hematol 3:351–375

    PubMed  CAS  Google Scholar 

  6. Weiss G, Godnough LT (2005) Anemia of chronic disease. N Engl J Med 352:1011–1023

    Article  PubMed  CAS  Google Scholar 

  7. Kemna E, Pickers P, Nemeth E et al (2005) Time-course analysis of hepcidin, serum iron, and plasma cytokine level in human injected with LPS. Blood 106:1864–1866

    Article  PubMed  CAS  Google Scholar 

  8. Kosuge T, Sawada T, Shimoda M et al (2010) Increased hepcidin production impairs iron metabolism after pancreatoduodenectomy. World J Surg 34:2452–2456. doi:10.1007/s00268-010-0657-3

    Article  PubMed  Google Scholar 

  9. Rabkin RA, Rabkin JM, Metacalf B et al (2004) Nutritional markers following duodenal switch for morbid obesity. Obes Surg 14:84–90

    Article  PubMed  Google Scholar 

  10. Uehata T, Tomosugi N, Shoji T et al. (2011) Serum hepcidin-25 levels and anemia in non-dialysis chronic kidney disease patients: a cross-sectional study. Nephrol Dial Transplant. doi:10.1093/ndt/gfr431

  11. Smyrniotis V, Farantos C, Kostopanagiotou G et al (2005) Vascular control during hepatectomy: review of methods and results. World J Surg 29:1384–1396. doi:10.1007/s00268-005-0025-x

    Article  PubMed  Google Scholar 

  12. Ganz T, Nemeth E (2011) Hepcidin and disorders of iron metabolism. Annu Rev Med 62:347–360

    Article  PubMed  CAS  Google Scholar 

  13. Gunshin H, Mackenzie B, Berger UV et al (1997) Cloning and characterization of a mammalian proton-coupled metal-ion transporter. Nature 388:482–488

    Article  PubMed  CAS  Google Scholar 

  14. Fleming RE (2007) Hepcidin activation during inflammation: make it STAT. Gastroenterology 132:447–449

    Article  PubMed  CAS  Google Scholar 

  15. Wrighting DM, Andrews NC (2006) Interleukin-6 induces hepcidin expression through STAT3. Blood 108:3204–3209

    Article  PubMed  CAS  Google Scholar 

  16. Pietrangelo A, Dierssen U, Valli I et al (2007) STAT3 is required for IL-6-gp130-dependent activation of hepcidin in vivo. Gastroenterology 132:294–300

    Article  PubMed  CAS  Google Scholar 

  17. Malyszko J (2009) Hepcidin assays: ironing out some details. Clin Am Soc Nephrol 4:1015–1016

    Article  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by a research grant from the Biomarker Society and by a grant-in-aid of the 106th Annual Congress of the Japan Surgical Society (JSS) Memorial Surgical Research Fund, Tokyo Japan.

Author information

Authors and Affiliations

  1. Second Department of Surgery, Dokkyo University School of Medicine, Kitakobayashi 880, Mibu, Shimotsuga, Tochigi, 321-0293, Japan

    Kyung Hwa Park, Tokihiko Sawada, Takayuki Kosuge, Junji Kita, Mitsugi Shimoda & Keiichi Kubota

  2. Proteomics Research Unit, Division of Advanced Medicine, Medical Research Institute, Kanazawa Medical College, Daigaku 1-1, Uchinada, Kanazawa, 920-0293, Japan

    Naohisa Tomosugi

Authors
  1. Kyung Hwa Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tokihiko Sawada
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takayuki Kosuge
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Junji Kita
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mitsugi Shimoda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Naohisa Tomosugi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Keiichi Kubota
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tokihiko Sawada.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Park, K.H., Sawada, T., Kosuge, T. et al. Surgical Inflammation Induces Hepcidin Production after Abdominal Surgery. World J Surg 36, 800–806 (2012). https://doi.org/10.1007/s00268-012-1473-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-012-1473-8

Keywords

Search

Navigation