Preview

Medical alphabet

Advanced search
Open Access Open Access  Restricted Access Subscription or Fee Access

Pathophysiology of anemic syndrome in celiac disease and its therapeutic treatment

https://doi.org/10.33667/2078-5631-2023-28-13-18

Abstract

The review presents modern ideas about the pathophysiology of the anemia syndrome associated with celiac disease. Brief information is provided about the main proteins involved in iron metabolism and their role in maintaining homeostasis. Attention is paid to the multifactorial pathogenetic mechanisms of anemia in celiac disease, the state of the duodenal mucosa and ultrastructural changes in the villi of enterocytes with signs of atrophy, which play a key role in the regulation of iron absorption, and also provides information on the mechanisms of the development of functional iron deficiency and its role in the pathogenesis of anemia of chronic diseases.

About the Authors

L. S. Oreshko
Military Medical Academy n. a. S. M. Kirov
Russian Federation

Oreshko Lyudmila S., DM Sci (habil.), professor, associate professor at 2nd Dept (Therapy for Advanced Training of Physicians)

Saint Petersburg



S. S. Ledentsova
Saint Petersburg State Pediatric Medical University
Russian Federation

Ledentsova Svetlana S., dermatologist of Consultative and Diagnostic Centre

Saint Petersburg



P. V. Seliverstov
Military Medical Academy n. a. S. M. Kirov
Russian Federation

Seliverstov Pavel V., PhD Med, associate professor at 2nd Dept (Therapy for Advanced Training of Physicians)

Saint Petersburg



S. P. Salikova
Military Medical Academy n. a. S. M. Kirov
Russian Federation

Salikova Svetlana P., DM Sci (habil.), associate professor at 2nd Dept (Therapy for Advanced Training of Physicians)

Saint Petersburg



E. S. Ivanyuk
Military Medical Academy n. a. S. M. Kirov
Russian Federation

Ivanyuk Elena S., PhD Med, gastroenterologist, associate professor at 2nd Dept (Therapy for Advanced Training of Physicians)

Saint Petersburg



References

1. Healthcare in Russia. 2019: Statistical collection. Rosstat. M., 2019. 170 p.

2. World Health Organization. Hemoglobin concentrations for diagnosing anemia and assessing severity. Information system on vitamin and mineral nutrition 2011. https://www.who.int/vmnis/indicators/haemoglobin.pdf

3. Gao G, Li J, Zhang Y, Chang YZ. Cellular Iron Metabolism and Regulation. Adv Exp Med Biol. 2019; 1173: 21–32. https://doi.org/10.1007/978–981–13–9589–5_2

4. Polyakova OA, Klepikova MV, Litvinova SN et аl. Iron deficiency and iron deficiency anemia in general medical practice. Preventive Medicine. 2022; 25 (12): 127–134. (In Russ.). https://doi.org/10.17116/profmed202225121127

5. Liu Q, Davidoff O, Niss K, Haase VH. Hypoxia-inducible factor regulates hepcidin via erythropoietin-induced erythropoiesis. J Clin Invest. 2012; 122 (12): 4635–4644. https://doi.org/10.1172/jci63924

6. Mastrogiannaki M, Matak P, Mathieu JR, et al. Hepatic hypoxia-inducible factor-2 down-regulates hepcidin expression in mice through an erythropoietin-mediated increase in erythropoiesis. Haematologica. 2012; 97 (6): 827–834. https://doi.org/10.3324/haematol.2011.056119

7. Lukina EA, Dezhenkova AV. Iron Metabolism in Normal and Pathological Conditions. Clinical Oncohematology. 2015; 8 (4): 355–361 (In Russ). https://doi.org/10.21320/2500–2139–2015–8–4–355–361

8. 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 (9): 1271–1276. https://doi.org/10.1172/jci20945

9. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med. 2005; 352 (10): 1011–1023. https://doi.org/10.1056/Nejmra041809

10. Nemeth E, Tuttle MS, Powelson J, et al. Hepcidin regulates cellular iron efflux by binding to ferroportin and inducing its internalization. Science. 2004; 306 (5704): 2090–2093. https://doi.org/10.1126/science.1104742

11. Ganz T, Nemeth E. Iron imports. IV. Hepcidin and regulation of body iron metabolism. Am J Physiol Gastrointest Liver Physiol. 2006; 290 (2): G199–G203. https://doi.org/10.1152/ajpgi.00412.2005

12. Oreshko L.S., Solovyeva E.A. Anemic manifestations in malabsorption syndrome and their correction. Gastroenterology of St. Petersburg. 2016; 1–2: 2–5 (in Russ.). URL: https://www.elibrary.ru/download/elibrary_28963584_13551003.pdf

13. Oreshko L. S., Bakulin I. G., Avalueva E. B. et аl. Modern understanding of adult celiac disease. Experimental and Clinical Gastroenterology. 2021; (4): 84–95. (In Russ.). https://doi.org/10.31146/1682–8658-ecg-188–4–84–95

14. Lázár-Molnár E, Snyder M. The Role of Human Leukocyte Antigen in Celiac Disease Diagnostics. Clin Lab Med. 2018; 38 (4): 655–668. https://doi.org/10.1016/j.cll.2018.07.007

15. Lejeune T, Meyer C, Abadie V. B Lymphocytes Contribute to Celiac Disease Pathogenesis. Gastroenterology. 2021; 160 (7): 2608–2610. e4. https://doi.org/10.1053/j.gastro.2021.02.063

16. Ludvigsson JF, Leffler DA, Bai JC, et al. The Oslo definitions for coeliac disease and related terms. Gut. 2013; 62 (1): 43–52. https://doi.org/10.1136/gutjnl-2011–301346

17. Leonard MM, Sapone A, Catassi C, Fasano A. Celiac Disease and Nonceliac Gluten Sensitivity: A Review. JAMA. 2017; 318 (7): 647–656. https://doi.org/10.1001/jama.2017.9730

18. Leffler DA, Green PH, Fasano A. Extraintestinal manifestations of coeliac disease. Nat Rev Gastroenterol Hepatol. 2015; 12 (10): 561–571. https://doi.org/10.1038/nrgastro.2015.131

19. Martín-Masot R, Nestares MT, Diaz-Castro J, et al. Multifactorial Etiology of Anemia in Celiac Disease and Effect of Gluten-Free Diet: A Comprehensive Review. Nutrients. 2019; 11 (11): 2557. Published 2019 Oct 23. https://doi.org/10.3390/nu11112557

20. Repo M, Lindfors K, Mäki M, et al. Anemia and Iron Deficiency in Children with Potential Celiac Disease. J Pediatr Gastroenterol Nutr. 2017; 64 (1): 56–62. https://doi.org/10.1097/MPG.0000000000001234

21. Freeman HJ. Iron deficiency anemia in celiac disease. World J Gastroenterol. 2015; 21 (31): 9233–9238. https://doi.org/10.3748/wjg.v21.i31.9233

22. Wierdsma NJ, van Bokhorst-de van der Schueren MA, Berkenpas M, Mulder CJ, van Bodegraven AA. Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients. Nutrients. 2013; 5 (10): 3975–3992. Published 2013 Sep 30. https://doi.org/10.3390/nu5103975

23. Berry N, Basha J, Varma N, et al. Anemia in celiac disease is multifactorial in etiology: A prospective study from India. JGH Open. 2018; 2 (5): 196–200. Published 2018 Aug 2. https://doi.org/10.1002/jgh3.12073

24. Oreshko L. S. Historical and clinical aspects of celiac disease. SPb, 2011; 108 р. (in Russ.)

25. Seidita A, Mansueto P, Compagnoni S, et al. Anemia in Celiac Disease: Prevalence, Associated Clinical and Laboratory Features, and Persistence after Gluten-Free Diet. J Pers Med. 2022; 12 (10): 1582. Published 2022 Sep 26. https://doi.org/10.3390/jpm12101582

26. Mullarky IK, Szaba FM, Kummer LW, et al. Gamma interferon suppresses erythropoiesis via interleukin-15. Infect Immun. 2007; 75 (5): 2630–2633. https://doi.org/10.1128/IAI.01836–06

27. Ludwiczek S, Aigner E, Theurl I, Weiss G. Cytokine-mediated regulation of iron transport in human monocytic cells. Blood. 2003; 101 (10): 4148–4154. https://doi.org/10.1182/blood-2002–08–2459

28. Stefanelli G, Viscido A, Longo S, Magistroni M, Latella G. Persistent Iron Deficiency Anemia in Patients with Celiac Disease Despite a Gluten-Free Diet. Nutrients. 2020; 12 (8): 2176. Published 2020 Jul 22. https://doi.org/10.3390/nu12082176

29. Bergamaschi G, Markopoulos K, Albertini R, et al. Anemia of chronic disease and defective erythropoietin production in patients with celiac disease. Haematologica. 2008; 93 (12): 1785–1791. https://doi.org/10.3324/haematol.13255

30. Bergamaschi G, Di Sabatino A, Corazza GR. Pathogenesis, diagnosis and treatment of anaemia in immune-mediated gastrointestinal disorders. Br J Haematol. 2018; 182 (3): 319–329. https://doi.org/10.1111/bjh.15254

31. Ludvigsson JF, Bai JC, Biagi F, et al. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut. 2014; 63 (8): 1210–1228. https://doi.org/10.1136/gutjnl-2013–306578

32. Annibale B, Severi C, Chistolini A, et al. Efficacy of gluten-free diet alone on recovery from iron deficiency anemia in adult celiac patients. Am J Gastroenterol. 2001; 96 (1): 132–137. https://doi.org/10.1111/j.1572–0241.2001.03463.x

33. Sharma M, Singh P, Agnihotri A, et al. Celiac disease: a disease with varied manifestations in adults and adolescents. J Dig Dis. 2013; 14 (10): 518–525. https://doi.org/10.1111/1751–2980.12078

34. Gulec S, Anderson GJ, Collins JF. Mechanistic and regulatory aspects of intestinal iron absorption. Am J Physiol Gastrointest Liver Physiol. 2014; 307 (4): G397–G409. https://doi.org/10.1152/ajpgi.00348.2013

35. Halfdanarson TR, Litzow MR, Murray JA. Hematologic manifestations of celiac disease. Blood. 2007; 109 (2): 412–421. https://doi.org/10.1182/blood-2006–07–031104

36. Dev S, Babitt JL. Overview of iron metabolism in health and disease. Hemodial Int. 2017; 21 Suppl 1(Suppl 1): S 6–S 20. https://doi.org/10.1111/hdi.12542

37. Rondanelli M, Faliva MA, Gasparri C, et al. Micronutrients Dietary Supplementation Advices for Celiac Patients on Long-Term Gluten-Free Diet with Good Compliance: A Review. Medicina (Kaunas). 2019; 55 (7): 337. Published 2019 Jul 3. https://doi.org/10.3390/medicina55070337

38. García-Manzanares A, Lucendo AJ. Nutritional and dietary aspects of celiac disease. Nutr Clin Pract. 2011; 26 (2): 163–173. https://doi.org/10.1177/0884533611399773

39. Gómez-Ramírez S, Brilli E, Tarantino G, Muñoz M. Sucrosomial® Iron: A New Generation Iron for Improving Oral Supplementation. Pharmaceuticals (Basel). 2018; 11 (4): 97. Published 2018 Oct 4. https://doi.org/10.3390/ph11040097

40. Bastida G, Herrera-de Guise C, Algaba A, et al. Sucrosomial Iron Supplementation for the Treatment of Iron Deficiency Anemia in Inflammatory Bowel Disease Patients Refractory to Oral Iron Treatment. Nutrients. 2021; 13 (6): 1770. Published 2021 May 22. https://doi.org/10.3390/nu13061770


Review

For citations:


Oreshko L.S., Ledentsova S.S., Seliverstov P.V., Salikova S.P., Ivanyuk E.S. Pathophysiology of anemic syndrome in celiac disease and its therapeutic treatment. Medical alphabet. 2023;(28):13-18. (In Russ.) https://doi.org/10.33667/2078-5631-2023-28-13-18

Views: 343


ISSN 2078-5631 (Print)
ISSN 2949-2807 (Online)