細胞激素於鐵泌素調節幽門桿菌相關鐵質缺乏之影響

The effects of inflammatory cytokines on the regulation of hepcidin in Helicobacter pylori induced iron deficiency

李權峻(Chuan-Chun Li)

指導教授 ： 曾博修

中山醫學大學/醫學院/生化微生物免疫研究所/碩士(2017年)

摘要

研究背景: 幽門桿菌感染是消化性潰瘍、胃癌和胃淋巴癌的重要影響因子，而鐵質缺乏及缺鐵性貧血是兒童幽門桿菌感染的重要併發症之一。由此可知幽門桿菌感染是鐵質缺乏的主要因素之一，並非完全是慢性消化性潰瘍出血所造成，故根除細菌比單純補充鐵劑的治療更佳，顯示細菌可能影響體內鐵質平衡。鐵泌素本是鐵質平衡的重要調節因子，過去發現幽門桿菌感染中，缺鐵性貧血的兒童體內的鐵泌素會上升，而刺激鐵泌素分泌的可能來源，包含體內鐵的儲存量或慢性發炎反應等，故幽門桿菌感染之細胞激素可能導致鐵質缺乏，目前並無研究報告，所以值得探討。

研究目的: 本研究主要在分析幽門桿菌感染兒童血清內之細胞激素與鐵泌素濃度，比較研究組與對照組的差異，藉以了解細胞激素濃度、鐵泌素及幽門桿菌感染之缺鐵性貧血與非缺鐵性貧血之關係。

研究方法: 本研究預計納入10-18歲幽門桿菌感染之兒童，對照組為無缺鐵性貧血(計51名)，實驗組為具缺鐵性貧血(計43名)，IDA將被定義為血清鐵飽和度低於15％。預計檢測各組別兒童血清中鐵泌素和細胞激素(例如:IL-1beta, IL-6, IL-8)之濃度，比較幽門桿菌有無感染之有無鐵質缺乏組別中，鐵泌素與細胞激素濃度之關係，了解細胞激素於幽門桿菌感染之缺鐵性貧血之角色。

預期成果: 本研究致力於了解兒童幽門桿菌感染導致鐵質缺乏中，細胞激素與鐵泌素之關係，有助於研究疾病機轉及釐清幽門桿菌對人類造成的影響。

關鍵詞 (Keywords): 細胞激素；幽門桿菌；鐵泌素；缺鐵性貧血

關鍵字

細胞激素 ； 幽門桿菌 ； 鐵泌素 ； 缺鐵性貧血

並列摘要

Background: H. pylori is a major pathogen of peptic ulcer disease, gastric cancer, and gastric B-cell lymphoma. Iron deficiency (ID) or iron deficiency anemia (IDA) has been considered as one of important H. pylori induced diseases in children. Studies showed that bacteria eradication plus iron supplement is much better than iron supplement only to treat H. pylori induced IDA. H. pylori, not chronic blood loss from peptic ulcers, indeed plays a key role in IDA. Hepcidin, an important iron regulatory hormone, seemed to increase on patients with H. pylori induced IDA. The regulation of hepcidin is known to rely on the status of iron storage and chronic inflammation (e.g. IL-6). However, whether chronic inflammation may induce hepcidin related iron homeostasis resulting in H. pylori induced ID is still unknown.

Aim: We try to understand the serum cytokine levels in children with H. pylori induced IDA, in comparison with those after bacteria eradication and those infected control children without IDA. The relationship between serum cytokine levels and hepcidin will be clarified.

Materials and methods: We will enroll H. pylori infected children, aged 10-18 years, into three groups: (1) control group, children with IDA (n=51); (2) study group, children with IDA (n=43). The IDA will be defined as a serum iron saturation below 15%. We will test the serum levels of hepcidin, cytokines (including IL-1beta, IL-6, IL-8,). Divided by different status, the relationship between cytokine levels and serum hepcidin will be analyzed in group.

Expected outcome: This study try to understand the role of serum cytokines in H. pylori induced IDA in children. It may also clarify that chronic inflammation might induce hepcidin related iron regulation in H. pylori induced IDA in children. It is important to realize the mechanism of H. pylori induced IDA in children and contribute to the management of clinical patients.

Keywords:Cytokines；Helicobacter pylori；hepcidin；iron deficiency

並列關鍵字

Cytokines ； Helicobacter pylori ； hepcidin ； iron deficiency

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