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Anemia of

Chronic

DisorderBambang KarsonoDepartment of Research and Development Dharmais Cancer Hospital

Division Hematology-Medical Oncology Department of Internal MedicineFaculty of Medicine University of Indonesia

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Anemia of Chronic Disorder Disease!

"econd most prevalent after iron deficiencyanemia

Occurs in patients #ith acute or chronic

immune activation$hus termed anemia of inflammation

Cyto%ines and R&" cells induce changes in'

Iron homeostasis(roliferation of erythroid progenitor cells

(roduction of erythropoietin

)ife span of R*C

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+eiss , et al .//0

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De Francisco A)M et al 1D$ (lus .//2

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Cancer Related Anemia

*ohlius 34 et al .//5

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Duodenal Mucosa Iron $ransport

Rouault $A .//0

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)ocali6ation and &7pression of HC(8

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HC(8 Facilitate &nergy Dependent

Fe-Heme Upta%e

"hayeghi M4 et al .//0

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Effect of Iron Status on HCP1 Localization in Brush

Border Enterocytes

"hayeghi M4 et al .//0

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HC(8 Facilitate Fe-Heme Upta%e

Caco-. Cell )ine

)atunde-Dada ,O4 et al .//5

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Closed 9ar' Dct8cR1A

Open 9ar' DC$8: IR&,8 cR1A

IR&,8 synonymto F(18

Mc;ie A$4 et al .///

F(18 Functions as Iron &7porter and

$ime Dependent

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F(18 Mostly &7pressed at

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Fpn Mutant Mice Accumulate

Iron in Enterocytes, Macrophaes, and Hepatocytes

Donovan A4 et al .//0

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Overe7pression F(18 Increase 1on Heme Iron

Release after Macrophage R*C (hagocytosis

;nutson MD4 et al .//0

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Zarychanski R, et al. 2008

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IF1- and )(" Reduced $fR mR1A )evel and

"urface &7pression and Counter Regulated 9y I)-8/

in Monocyte Cell )ine

)ud#ic6e% et al .//=

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IF1- and )(" Increased Cellular

&7pression of DM$8 in Monocyte Cell )ine

)ud#ic6e% et al .//=

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IF1- and )(" Do#n-regulates F(18 mR1A )evel

and Counter-acted 9y I)-8/ in Monocyte Cell )ine

)ud#ic6e% et al .//=

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$he &ffect of Inflammation on Hepcidin

mR1A and "erum Iron

1emeth &4 et al .//>

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Hepcidin Mar%edly Decreases

F(18 &7pression

;nutson MD4 et al .//0

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Hepcidin "ignificantly Reduced Mucosal

Iron Upta%e and $ransfer to $he Carcass

)aftah AH4 et al .//>

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Hepcidin $reatment Decreases Macrophage

1on Heme Iron Release

;nutson MD4 et al .//0

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Role of I)-5 in ACD

Andre#s 1C .//>

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Weiss G et al. 2005

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IF1- Do#n regulates

"CF-R and &(OR in

Human CFU-&

&rythropoietin4 "CFand I,F

synergistically

promote proliferation

and?or differentiation

of erythroid progenitor

cells and prevent

apoptosis

$aniguchi "4 et al 822@

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IL!1" and I#$!% Stimulates &e $o'o #erritin Synthesis

$ilg H4 et al .//.

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Weiss G et al. 2005

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Weiss G et al. 2005

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Weiss G et al. 2005

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