期刊
BLOOD
卷 123, 期 21, 页码 3221-3229出版社
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2013-10-533000
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资金
- Career Support Award from Oxford University Clinical Academic Graduate School
- Academy of Medical Sciences
- Wellcome Trust
- British Heart Foundation
- Arthritis Research UK
- UK MRC [MC-A760-5QX00]
- UK Department for International Development (DFID) under the MRC/DFID Concordat agreement
- Bill and Melinda Gates Foundation Global Health Grant (Hepcidin and Iron in Global Health, HIGH Partnership) [OPP1055865]
- Beit Memorial Fellowship for Medical Research
- MRC New Investigator award
- NIHR Oxford Biomedical Research Centre
- Wellcome Trust [091758]
- European Union FP7 EVIMalR Consortium
- Bill and Melinda Gates Foundation [OPP1055865] Funding Source: Bill and Melinda Gates Foundation
- Academy of Medical Sciences (AMS) [AMS-SGCL5-Atkinson] Funding Source: researchfish
- Medical Research Council [MC_UU_12010/10, MC_U123292699, G0901149] Funding Source: researchfish
- MRC [MC_U123292699, G0901149, MC_UU_12010/10] Funding Source: UKRI
Hepcidin is the master regulatory hormone that governs iron homeostasis and has a role in innate immunity. Although hepcidin has been studied extensively in model systems, there is less information on hepcidin regulation in global health contexts where iron deficiency (ID), anemia, and high infectious burdens (including malaria) all coexist but fluctuate over time. We evaluated iron status, hepcidin levels, and determinants of hepcidin in 2 populations of rural children aged <= 8 years, in the Gambia and Kenya (total n = 848), at the start and end of a malaria season. Regression analyses and structural equation modeling demonstrated, for both populations, similar combinatorial effects of upregulating stimuli (iron stores and to a lesser extent inflammation) and downregulating stimuli (erythropoietic drive) on hepcidin levels. However, malaria season was also a significant factor and was associated with an altered balance of these opposing factors. Consistent with these changes, hepcidin levels were reduced whereas the prevalence of ID was increased at the end of the malaria season. More prevalent ID and lower hepcidin likely reflect an enhanced requirement for iron and an ability to efficiently absorb it at the end of the malaria season. These results, therefore, have implications for ID and malaria control programs.
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