REVIEW PAPER
Anaemia of chronic diseases in rheumatoid arthritis
Online publication date: 2010-12-20
Reumatologia 2010;48(6):421-424
KEYWORDS
ABSTRACT
Anaemia of chronic diseases (ACD) is one of the most common hematologic abnormalities in patients with rheumatoid arthritis. It can be observed in a variety of conditions, including neoplastic, infectious and inflammatory diseases, heart failure or diabetes mellitus. However, until recently, little about its pathogenesis has been known. Inflammatory mediators such as tumour necrosis factor-alpha, interleukin-1, interleukin-6 and interlukin-10 play a role in this disorder. Hepcidin is one of key proteins in pathogenesis of ACD as it decreases iron absorption and iron release from macrophages. The pathogenesis of ACD is presented in this paper. Additionally, this review provides a summary of recent studies investigating the role of blocking interleukin-6 in rheumatoid arthritis patients with ACD. Inhibition of the interleukin-6 receptor with tocilizumab leads to an increase in haemoglobin levels as compared to placebo
REFERENCES (22)
1.
Wilson A, Yu HT, Goodnough LT, Nissenson AR. Prevalence and outcome of anemia in rheumatoid arthritis: a systematic review of the literature. Am J Med 2004; 116 (7A): 50S-57S. .
2.
Podolak-Dawidziak M. Niedokrwistości. W: Choroby wewnętrzne. Szczeklik A. (red.). Wyd. I, Medycyna Praktyczna, Kraków 2006. .
3.
Beutler E, Waalen J. The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? Blood 2006; 107: 1747. .
4.
Pazdur J. Niedokrwistość w zapalnych układowych chorobach tkanki łącznej. Nowa Med 1998; 5: 13-15. .
5.
Zimmermann-Górska I. Niedokrwistość chorób przewlekłych. W: Reumatologia kliniczna. Wydawnictwo Lekarskie PZWL, Warszawa 2008. .
6.
Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med 2005; 352: 1011-1023. .
7.
Papadaki HA, Kritikos HD, Valatas V, et al. Anemia of chronic disease in rheumatoid arthritis is associated with increased apoptosis of bone marrow erythroid cells: improvement following anti-tumor necrosis factor-alpha antibody therapy. Blood 2002; 100: 474-482. .
8.
Moldawer LL, Marano MA, Wei H, et al. Cachectin/tumor necrosis factor-alpha alters red blood cell kinetics and induces anemia in vivo. FASEB J 1989; 3: 1637-1643. .
9.
Voulgari PV, Kolios G, Papadopoulos GK, et al. Role of cytokines in the pathogenesis of anemia of chronic disease in rheumatoid arthritis. Clin Immunol 1999; 92: 153-160. .
10.
Nemeth E, Rivera S, Gabayan V, et al. IL-6 mediates hypoferremia of inflammation by inducing the synthesis of the iron regulatory hormone hepcidin. J Clin Invest 2004; 113: 1271-1276. .
11.
Atkins MB, Kappler K, Mier JW, et al. Interleukin-6 associated anemia: determination of the underlying mechanism. Blood 1995; 86: 1288-1291. .
12.
Ganz T. Hepcidin, a key regulator of iron metabolism and mediator of anemia of inflammation. Blood 2003; 102: 783-788. .
13.
Andrwes NC. Anemia of inflammation: the cytokine-hepcidin link. J Clin Invest 2004; 113: 1251-1253. .
14.
Raj DS. Role of interleukin-6 in the anemia of chronic disease. Semin Arthritis Rheum 2009; 38: 382-388. .
15.
Demirag MD, Haznedaroglu S, Sancak B, et al. Circulating hepcidin in the crossroads of anemia and inflammation associated with rheumatoid arthritis. Inter Med 2009; 48: 421-426. .
16.
Peeters HR, Jongen-Lavrencic M, Vreugdenhil G, Swaak AJ. Effect of recombinant human erythropoietin on anaemia and disease activity in patients with rheumatoid arthritis and anaemia of chronic disease: a randomized placebo controlled double blind 52 weeks clinical trial. Ann Rheum Dis 1996; 55: 739-744. .
17.
Peeters HR, Jongen-Lavrencic M, Bakker CH, et al. Recombinant human erythropoietin improves health-related quality of life in patients with rheumatoid arthritis and anaemia of chronic disease: utility measures correlate strongly with disease activity measures. Rheumatol Int 1999; 18: 201-206. .
18.
Han Ch, Rahman MU, Doyle MK, et al. Association of anemia and physical disability among patients with rheumatoid arthritis. J Rheumatol 2007; 34: 2177-2182. .
19.
Smolen JS, Beaulieu A, Rubbert-Roth A, et al. Effect of interleukin-6 receptor inhibition with tocilizumab in patients with rheumatoid arthritis (OPTION study): a double-blind, placebo-controlled, randomized trial. Lancet 2008; 371: 987-997. .
20.
Jones G, Sebba A, Gu J, et al. Comparison of tocilizumab monotherapy versus methotrexate monotherapy in patients with moderate to severe rheumatoid arthritis: The AMBITION study. Ann Rheum Dis 2010; 69: 88-96. .
21.
Emery P, Keystone E, Tony HP. IL-6 receptor inhibition with tocilizumab improves treatment outcomes in patients with rheumatoid arthritis refractory to anti-tumour necrosis factor biological: results from a 24-week multicentre randomized placebo-controlled trial. Ann Rheum Dis 2008; 67: 1516-1523. .
22.
Genovese MC, McKay JD, Nasonov EL, et al. Interleukin-6 receptor inhibition with tocilizumab reduces disease activity in rheumatoid arthritis with inadequate response to disease-modifying antirheumatic drugs: the tocilizumab in combination with traditional disease-modifying antirheumatic drug therapy study. Arthritis Rheum 2008; 58: 2968-2980.
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Share
RELATED ARTICLE
| eISSN: | 2084-9834 |
| ISSN: | 0034-6233 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
