Document Detail


Greater potency of darbepoetin-α than erythropoietin in suppression of serum hepcidin-25 and utilization of iron for erythropoiesis in hemodialysis patients.
MedLine Citation:
PMID:  23281632     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The potency of darbepoetin-α (DPO-α) to improve anemia in hemodialysis (HD) patients is greater than that of recombinant human erythropoietin (rHuEPO).
DESIGN AND METHODS: To assess the potency of DPO-α to mobilize iron from body stores in comparison with rHuEPO in HD patients without apparent inflammation or infection, serum iron, transferrin saturation (TSAT), ferritin, and hepcidin-25 were measured serially. This study included (i) a long-term crossover study for 3 yr to compare the effects of the two erythropoiesis-stimulating agents (ESA) on serum iron, TSAT, and ferritin, and (ii) a short-term crossover study for 8 wk to examine their effects on serum hepcidin-25 in HD patients.
RESULTS: The long-term crossover study demonstrated that the change of ESA from rHuEPO to DPO-α significantly decreased serum ferritin while serum iron and TSAT remained unchanged, while DPO-α as well as rHuEPO maintained hemoglobin level in the target range between 10.0 and 11.0 g/dL. Furthermore, in the short-term crossover study, area under the percent suppression of serum hepcidin-25 time curve for the first 7 d during the DPO-α treatment period was significantly greater than that during the rHuEPO period (348.0 ± 92.4 vs. 178.4 ± 131.5%.day P = 0.030). The greater suppression of hepcidin-25 by DPO-α may facilitate iron mobilization, resulting in diminution of body iron stores without any significant effect on serum iron utilizable for erythropoiesis.
CONCLUSION: This study demonstrated that DPO-α has a greater advantage than rHuEPO in that it facilitates iron mobilization from body stores into bone marrow to induce effective erythropoiesis and thus could protect against possible harmful effects caused by excessive iron stores in the body.
Authors:
Shigeichi Shoji; Masaaki Inaba; Naohisa Tomosugi; Senji Okuno; Mitsuru Ichii; Tomoyuki Yamakawa; Satoshi Kurihara
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of haematology     Volume:  90     ISSN:  1600-0609     ISO Abbreviation:  Eur. J. Haematol.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-15     Completed Date:  2013-04-05     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  8703985     Medline TA:  Eur J Haematol     Country:  England    
Other Details:
Languages:  eng     Pagination:  237-44     Citation Subset:  IM    
Copyright Information:
© 2013 John Wiley & Sons A/S.
Affiliation:
Shirasagi Hospital, Osaka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anemia / drug therapy*,  etiology,  metabolism
Antimicrobial Cationic Peptides / antagonists & inhibitors*,  blood
Area Under Curve
Cross-Over Studies
Erythropoiesis / drug effects*
Erythropoietin / analogs & derivatives*,  pharmacology,  therapeutic use*
Female
Ferritins / blood
Hematinics / pharmacology,  therapeutic use*
Hemoglobins / analysis
Humans
Iron / metabolism*
Kidney Failure, Chronic / metabolism,  therapy
Male
Middle Aged
Recombinant Proteins / pharmacology,  therapeutic use
Renal Dialysis / adverse effects
Chemical
Reg. No./Substance:
0/Antimicrobial Cationic Peptides; 0/Hematinics; 0/Hemoglobins; 0/Recombinant Proteins; 0/hepcidin 25, human; 11096-26-7/Erythropoietin; 15UQ94PT4P/darbepoetin alfa; 7439-89-6/Iron; 9007-73-2/Ferritins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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