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Blood, 15 May 2005, Vol. 105, No. 10, pp. 4103-4105.
Prepublished online as a Blood First Edition Paper on January 25, 2005; DOI 10.1182/blood-2004-12-4844.
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RED CELLS Brief report
Hepcidin in iron overload disorders
George Papanikolaou,
Michalis Tzilianos,
John I. Christakis,
Dionisios Bogdanos,
Konstantina Tsimirika,
Julie MacFarlane,
Y. Paul Goldberg,
Nikos Sakellaropoulos,
Tomas Ganz, and
Elizabeta Nemeth
From the First Department of Medicine, National and Kapodistrian University of Athens; Blood Bank Unit, Corfu General Hospital; Department of Hematology, Theagenion Cancer Center, Thessaloniki, Greece; Xenon Pharmaceuticals, Burnaby, British Columbia, Canada; and Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles.
Hepcidin is the principal regulator of iron absorption in humans. The peptide inhibits cellular iron efflux by binding to the iron export channel ferroportin and inducing its internalization and degradation. Either hepcidin deficiency or alterations in its target, ferroportin, would be expected to result in dysregulated iron absorption, tissue maldistribution of iron, and iron overload. Indeed, hepcidin deficiency has been reported in hereditary hemochromatosis and attributed to mutations in HFE, transferrin receptor 2, hemojuvelin, and the hepcidin gene itself. We measured urinary hepcidin in patients with other genetic causes of iron overload. Hepcidin was found to be suppressed in patients with thalassemia syndromes and congenital dyserythropoietic anemia type 1 and was undetectable in patients with juvenile hemochromatosis with HAMP mutations. Of interest, urine hepcidin levels were significantly elevated in 2 patients with hemochromatosis type 4. These findings extend the spectrum of iron disorders with hepcidin deficiency and underscore the critical importance of the hepcidinferroportin interaction in iron homeostasis.

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