System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Ppublish

PubMed: 40637365 DOI: 10.1111/pim.70014

Relationship Between Hepcidin, Iron Metabolism, Inflammation and Hypersplenism in Anaemia of Kala-Azar.

Parasite Immunol 47(7):e70014

Authors: Alyne Ferreira De Almendra Freitas, Adelino Soares Lima Neto, Camila Maria Coelho de Moura, Giovana Dias Silva, Marília de Sousa Araújo Barbosa E Silva, Keline Medeiros de Araújo Vilges, Francisco Mateus Alves de Morais Ferreira, Dorcas Lamounier Costa, Carlos Henrique Nery Costa

Affiliations

  • Postgraduate Program in Health and Science, Federal University of Piauí, Teresina, Piauí, Brazil. Leishmaniasis Research Laboratory - LabLeish, Piauí, Brazil.
  • Dr. Costa Alvarenga Central Public Health Laboratory (LACEN), Teresina, Piauí, Brazil.
  • Federal University of Piauí, Teresina, Piauí, Brazil.
  • Leishmaniasis Research Laboratory - LabLeish, Piauí, Brazil.
  • Center for Intelligence on Emerging and Neglected Tropical Diseases (CIATEN), Teresina, Piauí, Brazil.
  • Federal University of Paraíba, João Pessoa, Paraíba, Brazil.
  • University of Brasilia Campus Darcy Ribeiro, Brasilia - DF, Brazil.
  • Municipal Government of João Pessoa-PB, João Pessoa, Paraíba, Brazil.
  • Leishmaniasis Research Laboratory - LabLeish, Piauí, Brazil. Federal University of Piauí, Teresina, Piauí, Brazil. Center for Intelligence on Emerging and Neglected Tropical Diseases (CIATEN), Teresina, Piauí, Brazil.

Abstract

Kala-azar, or visceral leishmaniasis (VL), is a parasitic disease caused by Leishmania spp., characterised by fever, weight loss, splenomegaly, hepatomegaly, and anaemia. This study evaluated the relationship between hepcidin, inflammation, iron metabolism, and hypersplenism in VL-associated anaemia. In this cross-sectional study, confirmed VL patients without recent transfusions were assessed. Haematological and inflammatory parameters were analysed using correlation and multivariate regression tests. Anaemia was present in 95.2% of the sample, predominantly normocytic (59.5%) and normochromic (76.2%), or microcytic (40.5%) and hypochromic (23.8%). Inflammatory markers were markedly elevated in most patients, particularly hepcidin, which was increased in 97.6% of cases (median: 351.46 ng/mL), suggesting persistent inflammation and impaired iron bioavailability. However, IL-6, CRP, and ferritin showed weak to moderate negative correlations with hepcidin (ρ = -0.33, ρ = -0.66, and ρ = -0.30, respectively). These findings highlight the complex interplay between anaemia and inflammation in kala-azar, with elevated hepcidin levels and paradoxical correlations with inflammatory markers. They underscore the central role of splenomegaly in VL-related anaemia and suggest potential contributions from other factors affecting iron metabolism, such as erythropoietin and erythroferrone. Understanding the dynamics of these markers throughout disease progression and treatment may further elucidate the pathophysiology of VL and support the development of targeted therapies.

MeSH

Splenomegaly, Hepcidins, Anemia, Hypersplenism, Therapeutics, Leishmaniasis, Visceral