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THE PATHOPHYSIOLOGY OF ANEMIA

The cells and cytokines of the reticuloendothelial system contribute to changes in the iron homeostasis, erythroid progenitor cells proliferation, changes in the red cells lifespan, and the erythropoietin production which lead to anemia’s pathogenesis. The inflammation involves three significant steps on the regular erythropoietin.

THE PATHOPHYSIOLOGY OF ANEMIA
THE PATHOPHYSIOLOGY OF ANEMIA

The effects are blunting of the erythropoietin biology activity leading to the stimulating hormone- erythropoiesis. The second step is the diversion of iron traffic that contributes to metal retention in macrophages and contributes to the iron-deficient erythropoiesis. The last step involves inhibition of proliferation and differentiation of the cells of the erythroid progenitor. Body changes in iron distribution are by acute phase proteins and the cytokines. Additionally, the iron homeostasis is the, faster regulator of hepcidin that is produced by the liver in response to the overload of iron. It also happens as a result of pro-inflammatory stimuli such as the interleukin-6 and lipopolysaccharide (Weiss, and Goodnough, 2005).

From its biological function, the Hepcidin binds with ferroportin (SLC40A1), the cellular iron exporter leading to ferroportin degradation and interaction. This effect blocks the absorption of iron from their transfer to the duodenal enterocyte in circulation. The effect is aggravated by the necrosis factor (TNF)-α tumor and also causes the retention of iron within the monocytes and macrophages (Gomollon and Gisbert, 2009). The effect is significant since the macrophages function in reutilizing iron released by the senescent red blood cell and are later taken up through the erythroid- phagocytosis. There is the recycling of iron within the phagocytes via the heme and delivered trough enzymatic degradation through the circulation of ferroportin. However, in the case of the inflammatory process, the erythrocytes biological half-life is reduced to the oxidative stress consequences and lipid peroxidation. This lead to the promotion of erythroid- phagocytosis and it reduces the recirculation of iron. Also, the anti- and pro-inflammatory cytokines further contribute to the retention of iron within the macrophages/ monocytes and it stimulates the uptake of iron by pathways while inhibiting the ferroportin transcription in the cells (Ludwiczek, et al., 2003).

Similarities and differences between iron deficiency anemia and chronic inflammation anemia

Iron deficiency causes both chronic inflammation anemia and iron deficiency anemia. Chronic inflammation anemia is as the result of iron deficiency that is the only problem. But for the chronic inflammatory anemia, it involves other complicated aspects including the storage of iron in hemosiderin and ferritin to the impact on the red cells. Iron deficiency anemia and happens as a result of the total decrease of iron in the body. Chronic inflammatory anemia is as a consequence of a constant reduction in erythropoiesis. Chronic inflammation anemia occurs when there is normal storage of iron but inflammation interferes with the ability of the body to absorb or store iron from the diet. Anemia of inflammation also occurs with a type of chronic infections and long-term illnesses which impact on the average activation and function of the immune systems.

Age

Chronic inflammation anemia can affect any person at any age, but adults are more at risk since they have the greater risk of chronic illness. Chronic inflammatory anemia is especially common among the hospitalized patients suffering from chronic disease (CDC, 2012).

References

Chronic diseases and health promotion. Centers for Disease Control and Prevention website.

Gomollon F, Gisbert JP. Anemia and inflammatory bowel diseases. World J Gastroenterol. 2009;15(37):4659–65.

Ludwiczek S, Aigner E, Theurl I, Weiss G. Cytokine-mediated regulation of iron transport in human monocytic cells. Blood. 2003;101(10):4148–54

Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med. 2005;352(10):1011–23.

Sherry Roberts is the author of this paper. A senior editor at MeldaResearch.Com in college research papers if you need a similar paper you can place your order for order research paper.

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