Abstract
Objective: To preliminary study the significance of low molecular weight heparin (LMWH) in the treatment patients of with anemia of chronic diseases (ACD), and the changes in the serum levels of BMP6, hepcidin and IL-6. To preliminary study the significance of low molecular weight heparin (LMWH) in the treatment the patients with anemia of chronic diseases (ACD), and the changes in the serum levels of BMP6, hepcidin and IL-6. Methods: Used LMWH (4000 u/day, 7 - 15 days) to therapy 61 patients with ACD, and ELISA method was used to determine Hepcidin and BMP6 before and after treatment, and the determination of IL-6 by Electro-chemi-luminescence, and to analyze its clinical significance. Results: 1) In all 61 cases, the levels of Hepcidin in post-therapy were 0.82 ± 0.24 mg/L, which were lower than 1.05 ± 3.83 mg/L in pre-therapy (t = 2.5726, P P P > 0.05). However, The levels of Hb in post-therapy were higher than in pre-therapy (t = 1.9832, P P P P P > 0.05). 5) Although Hb level increased slightly in the non-tumor anemia group, there was no statistical significance (P > 0.05), and there was no statistical difference in other indexes (all P > 0.05). 6) After treatment, the level of Hb was negatively correlated with Hepcidin and IL-6 (respectively r = -0.2809, t = 2.2490, P P P < 0.05). There was no correlation between BMP6 and Hb, Hepcidin and IL-6 levels. Conclusion: LMWH could up-regulate the levels of Hb, and better for the degree of anemia in patients with ACD. The possible mechanism is to reduce the level of Hepcidin and IL-6.
Highlights
IntroductionIt has been confirmed that the inflammatory response of patients with chronic anemia (anemia of chronic disease, ACD) leads to the high expression of interleukin-6 (interleukin-6, IL-6) and the high expression of ferritin ( known as a liver antimicrobial polypeptide, Hepcidin, referred to as Hep), and leads to anemia
At present, it has been confirmed that the inflammatory response of patients with chronic anemia leads to the high expression of interleukin-6 and the high expression of ferritin, and leads to anemia
To preliminary study the significance of low molecular weight heparin (LMWH) in the treatment patients of with anemia of chronic diseases (ACD), and the changes in the serum levels of BMP6, hepcidin and IL-6
Summary
It has been confirmed that the inflammatory response of patients with chronic anemia (anemia of chronic disease, ACD) leads to the high expression of interleukin-6 (interleukin-6, IL-6) and the high expression of ferritin ( known as a liver antimicrobial polypeptide, Hepcidin, referred to as Hep), and leads to anemia. It has been reported that heparin can improve anemia in ACD. The mechanism may be that heparin down-regulates the expression of Hep through the bone morphogenic protein 6 (bone morphogenetic protein 6, BMP6) pathway. It was shown that commercial heparins are potent hepcidin inhibitors in vitro in HepG2 cells and in vivo in healthy mice and that act by inhibiting the BMP6/SMAD signaling. Heparins are well-characterized molecules with some 70 years of clinical experience, and appealing drugs for the treatment of anemia. Based on early clinical observation of low molecular weight heparin (low molecular weight Heparin, LMWH) in the treatment of tumor-associated anemia, we further observed the changes of hemoglobin (Hb) level, BMP6, IL-6, and Hepcidin in patients with ACD after LMWH treatment. To analyze the clinical significance and possible mechanism of LMWH in the treatment of ACD
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