Is iron deficiency caused by BMPR2 mutations or dysfunction in pulmonary arterial hypertension patients?

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Vivienne Theobald - , University Hospital Heidelberg (Author)
  • Ekkehard Grünig - , University Hospital Heidelberg (Author)
  • Nicola Benjamin - , University Hospital Heidelberg (Author)
  • Hans-Jürgen Seyfarth - , University Hospital Leipzig (Author)
  • Michael Halank - , Department of internal Medicine I, University Hospital Carl Gustav Carus Dresden (Author)
  • Marc A Schneider - , Translational Lung Research Center Heidelberg (TLRC) - DZL Heidelberg (Author)
  • Sarah Richtmann - , Translational Lung Research Center Heidelberg (TLRC) - DZL Heidelberg (Author)
  • Daniel Kazdal - , Translational Lung Research Center Heidelberg (TLRC) - DZL Heidelberg (Author)
  • Katrin Hinderhofer - , Heidelberg University  (Author)
  • Panagiota Xanthouli - , University Hospital Heidelberg (Author)
  • Benjamin Egenlauf - , University Hospital Heidelberg (Author)
  • Satenik Harutyunova - , University Hospital Heidelberg (Author)
  • Marius M Hoeper - , Hannover Medical School (MHH) (Author)
  • Danny Jonigk - , Leibniz University Hannover (LUH) (Author)
  • Richard Sparla - , Translational Lung Research Center Heidelberg (TLRC) - DZL Heidelberg (Author)
  • Martina U Muckenthaler - , Translational Lung Research Center Heidelberg (TLRC) - DZL Heidelberg (Author)
  • Christina A Eichstaedt - , University Hospital Heidelberg (Author)

Abstract

Iron deficiency is common in idiopathic and heritable pulmonary arterial hypertension patients (I/HPAH). A previous report suggested a dysregulation of the iron hormone hepcidin, which is controlled by BMP/SMAD signaling involving the bone morphogenetic protein receptor 2 (BMPR-II). Pathogenic variants in the BMPR2 gene are the most common cause of HPAH. Their effect on patients' hepcidin levels has not been investigated. The aim of this study was to assess whether iron metabolism and regulation of the iron regulatory hormone hepcidin was disturbed in I/HPAH patients with and without a pathogenic variant in the gene BMPR2 compared to healthy controls. In this explorative, cross-sectional study hepcidin serum levels were quantified by enzyme-linked immunosorbent assay. We measured iron status, inflammatory parameters and hepcidin modifying proteins such as IL6, erythropoietin, and BMP2, BMP6 in addition to BMPR-II protein and mRNA levels. Clinical routine parameters were correlated with hepcidin levels. In total 109 I/HPAH patients and controls, separated into three groups, 23 BMPR2 variant-carriers, 56 BMPR2 noncarriers and 30 healthy controls were enrolled. Of these, 84% had iron deficiency requiring iron supplementation. Hepcidin levels were not different between groups and corresponded to the degree of iron deficiency. The levels of IL6, erythropoietin, BMP2, or BMP6 showed no correlation with hepcidin expression. Hence, iron homeostasis and hepcidin regulation was largely independent from these parameters. I/HPAH patients had a physiologically normal iron regulation and no false elevation of hepcidin levels. Iron deficiency was prevalent albeit independent of pathogenic variants in the BMPR2 gene.

Details

Original languageEnglish
Pages (from-to)e12242
JournalPulmonary circulation
Volume13
Issue number2
Publication statusPublished - Apr 2023
Peer-reviewedYes

External IDs

PubMedCentral PMC10247310
Scopus 85162103320

Keywords