贫血治疗：铁代谢与贫血.pptx

铁代谢与贫血
铁代谢与贫血
W铁稳态调节
生理状态下铁的吸收、转运、 再循环利用及丢失
Dietary iron
Utilization
Retie u lo-endothe I ia I macrophages
(60-2 (T cell immunoglobulin and mucin domain containing 2)
*Heme importer: enterocytic, SLC48A1
*Cells also acquire heme indirectly: intravascular hemolysis
铁稳态的维持：
两个调节系统
寸 Functions systemically:
Hepcidin/Ferroportin
4 Cellular iron metabolism:
IRP/IRE
HEPCIDIN起中心的调节作用
肝脏产生
调节肠道吸收巨噬细胞铁循环肝脏贮存铁释放
<^Hepcidin^)
Plasma iron
肠腔
Fe
Fe
Fe
1„HJ
DMT1
Fe
ferroportin
血液
Fe Fe Fe
缺铁时Hepcidin合成减少, Ferroportin表达增加
Fe
Fe
Fe
DMT1
铁过多时,肝脏Hepcidin合 成增加,与Ferroportin作用, 内化、降解后者
Regulation of Hepcidin Expression
Regulation by Systemic Iron Availability
Normal Iron Absorption
Intestinal enterocyte
Normal plasma hepcidin levels
Normal iron uptake
Plasma
*
*
Normal
*
plasma iron
iron export
Hepatocyte
Hepcidin-mediated ferroportin degradation
* Fe
♦ Hepcidin
Ferroportin
a Degraded ferroportin
Iron Deficiency
Reduced
.Increased enterocyte iron uptake
Macrophage
Plasma
* *
Reduced plasma hepcidin levels
Reduced * plasma iron
*
Hepatocyte
Ferroportin-mediated iron export
* Fe
♦ Hepcidin
Ferroportin
B Degraded ferroportin
Iron Overload
*
High plasma hepcidin levels
剛WWW
* *
Intestinal enterocyte *
Decreased
Macrophage
Increased iron stores
iron uptake
来 ♦ *
*Plasma** 工
Increased 奈 * plasma iron * * *♦ ♦♦♦』
Hepcidin-mediated ferroportin degradation
High hepcidin expression
/ Hepatocyte
* Fe
♦ Hepcidin
Ferroportin
B Degraded ferroportin
铁代谢与贫血
寸缺铁性贫血
Prevalence of Anemia, ID, and IDA
Prevalence (%)
Anaemia
General population20 32-9
Men (15-60 ye^rs)21 12 7
School - age cH i I cl re n ( >S years)?' 25-4
Elderly (>GO years)21 23-9
Preschool children (0—5 years)22 43-0
Non-preg nanl: women and girls (15—49 years)22 29-0
Preqnant women and qi rls (二5—49 years产 38。 .
Iron def