The value of erythropoietin in the pathogenesis of anemia of chronic diseases in the rheumatic patients
- Authors: Sakhin V.T.1, Kryukov E.V.2, Grigoriev M.A.3, Kazakov S.P.4, Sotnikov A.V.2, Gordienko A.V.2, Nosovich D.V.2, Rukavitsyn O.A.4
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Affiliations:
- 3rd Central Military Clinical Hospital named after A.A. Vishnevsky of the Ministry of Defense of the Russian Federation
- Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
- Leningrad Regional Clinical Hospital
- Main Military Hospital named after N.N. Burdenko of the Ministry of Defense of the Russian Federation
- Issue: Vol 23, No 4 (2021)
- Pages: 55-62
- Section: Clinical trials
- URL: https://journals.rcsi.science/1682-7392/article/view/71556
- DOI: https://doi.org/10.17816/brmma71556
- ID: 71556
Cite item
Abstract
The features of erythropoietin secretion in patients with a rheumatic pathology and anemia of the chronic diseases in comparison with patients having iron deficiency anemia, as well as the relationship between erythropoietin, hepcidin, proinflammatory, and antiinflammatory cytokines, have been investigated. 126 patients suffering from the rheumatic pathology were examined, including 34 men aged 36–55 years and 92 women aged 38–60 years. At the same time, 104 (82.5%) patients suffered from anemia, 22 (17.5%) patients did not have it. Patients suffering from anemia, depending on the leading pathogenetic factor, were divided into three groups such as: the 1st group — patients suffering from anemia of chronic diseases; 2nd group—patients suffering from a combination of anemia of chronic diseases and iron deficiency anemia; 3rd group—patients suffering from iron deficiency anemia. In patients suffering from anemia of chronic diseases, the maximum concentration of interleukin-6, hepcidin, and the minimum concentration of erythropoietin were detected in comparison with the patients suffering from iron deficiency anemia and patients suffering from anemia of chronic diseases, and iron deficiency anemia (p < 0.05). The maximum concentration of the erythropoietin has been established in patients suffering from iron deficiency anemia. About the concentrations of interleukin-10 and interleukin-1β, tumor necrosis factor-α, interferon-γ, no differences were found in the study groups. A direct correlation was found between the erythropoietin and erythrocytes (r = 0.57), hemoglobin (r = 0.41), hepcidin (r = 0.65). There was a strong negative correlation between the erythropoietin and interleukin-6 (r = –0.75), and a weak relationship with interferon gamma, tumor necrosis factor alpha, interleukin-10, and interleukin-1β (r < 0.3). Thus, for patients with a rheumatic profile, a specific molecular profile should be identified, leading to the development of anemia of the chronic diseases, which consists in increased concentrations of hepcidin and interleukin-6 in combination with the insufficient secretion of erythropoietin. The found changes fit into the structure of the previously proposed working version of the classification of anemia of chronic diseases (with a predominant iron deficiency, with disturbances in the regulatory mechanisms of the erythropoiesis, with an insufficient production of erythropoietin). Isolation of the leading factor in the development of anemia of chronic diseases in the future will allow for a more optimal approach to its correction, including with the targeted therapy drugs.
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##article.viewOnOriginalSite##About the authors
Valery T. Sakhin
3rd Central Military Clinical Hospital named after A.A. Vishnevsky of the Ministry of Defense of the Russian Federation
Author for correspondence.
Email: SahinVT@yandex.ru
ORCID iD: 0000-0001-5445-6028
SPIN-code: 4895-5411
candidate of medical sciences
Russian Federation, KrasnogorskEvgeniy V. Kryukov
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: evgeniy.md@mail.ru
ORCID iD: 0000-0002-8396-1936
SPIN-code: 3900-3441
Scopus Author ID: 57208311867
doctor of medical sciences, professor
Russian Federation, Saint PetersburgMaxim A. Grigoriev
Leningrad Regional Clinical Hospital
Email: moxim56@rambler.ru
ORCID iD: 0000-0003-3586-9067
Russian Federation, Saint Petersburg
Sergey P. Kazakov
Main Military Hospital named after N.N. Burdenko of the Ministry of Defense of the Russian Federation
Email: gvkg.ckdl@mail.ru
ORCID iD: 0000-0001-6528-1059
SPIN-code: 5560-3931
doctor of medical sciences, professor
Russian Federation, MoscowAlexey V. Sotnikov
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: sotnikovav@inbox.ru
SPIN-code: 3295-8212
Scopus Author ID: 57198115199
doctor of medical sciences
Russian Federation, Saint PetersburgAleksandr V. Gordienko
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: gord503@mail.ru
ORCID iD: 0000-0002-6901-6436
SPIN-code: 5049-3501
doctor of medical sciences, professor
Russian Federation, Saint PetersburgDmitriy V. Nosovich
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: nozovich@mail.ru
ORCID iD: 0000-0003-2891-4747
SPIN-code: 2318-4509
candidate of medical sciences
Russian Federation, Saint PetersburgOleg A. Rukavitsyn
Main Military Hospital named after N.N. Burdenko of the Ministry of Defense of the Russian Federation
Email: ngc@list.ru
ORCID iD: 0000-0002-1309-7265
doctor of medical sciences, professor
Russian Federation, MoscowReferences
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