Anemia of Inflammation: A Review

Med Clin North Am. 2017 Mar;101(2):285-296. doi: 10.1016/j.mcna.2016.09.005. Epub 2016 Dec 24.

Abstract

Impaired iron homeostasis and the suppressive effects of proinflammatory cytokines on erythropoiesis, together with alterations of the erythrocyte membrane that impair its survival, cause anemia of inflammation. Recent epidemiologic studies have connected inflammatory anemia with critical illness, obesity, aging, kidney failure, cancer, chronic infection, and autoimmune disease. The proinflammatory cytokine, interleukin-6, the iron regulatory hormone, hepcidin, and the iron exporter, ferroportin, interact to cause iron sequestration in the setting of inflammation. Although severe anemia is associated with adverse outcomes in critical illness, experimental models suggest that iron sequestration is part of a natural defense against pathogens.

Keywords: Anemia; Cancer; Erythroferrone; Ferroportin; Hepcidin; Inflammation; Interleukin-6; Iron.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Anemia / etiology*
  • Anemia / physiopathology*
  • Animals
  • Cation Transport Proteins / metabolism
  • Critical Illness / mortality
  • Cytokines / metabolism
  • Erythrocyte Membrane / physiology
  • Erythropoiesis / physiology
  • Hepcidins / metabolism
  • Humans
  • Inflammation / complications*
  • Inflammation / etiology
  • Interleukin-6 / metabolism
  • Iron / metabolism
  • Neoplasms / chemistry
  • Obesity / complications
  • Peptide Hormones / metabolism
  • Renal Insufficiency / complications
  • Rheumatic Diseases / complications
  • Severity of Illness Index

Substances

  • Cation Transport Proteins
  • Cytokines
  • Erfe protein, human
  • Hepcidins
  • Interleukin-6
  • Peptide Hormones
  • metal transporting protein 1
  • Iron