铁代谢红系调节因子在不同类型红系造血异常疾病中的表达

OBJECTIVE: To investigate the expression of iron-regulating erythroid factors in different types of erythropoiesis disorders. METHODS: From January 2016 to November 2019, the plasma concentrations of iron-regulating erythroid factors were measured by ELISA methods in 47 patients with different types of erythropoiesis disorders. The adaptation orientation of iron-regulating erythroid factor expression with bone marrow erythropoiesis activities (represented by bone marrow-nucleated erythrocytes ratio) was analyzed. RESULTS: The median plasma growth differentiation factor (GDF) 15 levels in patients with polycythemia vera (PV), pure red cell aplasia (PRCA), autoimmune hemolytic anemia (AIHA), and myelodysplastic syndrome (MDS) were 266.01 ng/L (112.40, 452.37), 110.63 ng/L (81.41, 220.42), 52.11 ng/L (32.61, 171.66), and 276.53 (132.16, 525.70) ng/L, respectively, which were significantly higher than those in normal patients with 37.45 (19.65, 57.72) ng/L (all P < 0.01). The plasma TWSG1 expression levels were not significantly different in patients with PV, PRCA, AIHA, and MDS from those of normal patients (P>0.05). The median plasma GDF11 level in PV was 74.75 (10.95, 121.32) ng/L, which was significantly higher than 36.90 (3.38, 98.34) ng/L in normal control subjects (P<0.01). However, no statistical differences were observed in the other three subjects (P>0.05). The median plasma erythroferrone (ERFE) levels in AIHA and PV were 121.76 ng/L (68.12, 343.11) and 129.63 (47.02, 170.03) ng/L, respectively, with the highest level in AIHA in all the studied types of erythropoiesis disorders. The bone marrow-nucleated erythrocytes ratio was significantly and positively correlated with ERFE (r=0.458, P=0.001) but not with GDF15 (r=−0.163, P=0.274), GDF11 (r=0.120, P=0.421), and TWSG1 (r=−0.166, P=0.269). CONCLUSION: The expression profile of iron-regulating erythroid factors is not exactly the same in different types of erythropoiesis disorders. ERFE demonstrated the highest correlation with erythropoiesis activities.