Hepcidin, the master regulator of iron homeostasis, causes iron deficiency anaemia of chronic disease by:

• A Inhibiting erythropoietin synthesis in the kidney
• B Competitively inhibiting DMT-1 iron transporter in the duodenum
• C Upregulating transferrin receptor 2 to sequester transferrin-bound iron
• D Binding and inducing degradation of ferroportin on enterocytes and macrophages, reducing iron absorption and recycling ✓

Explanation

Hepcidin (produced by the liver in response to IL-6 and iron loading) binds ferroportin (the only known cellular iron exporter) on enterocytes, macrophages, and hepatocytes, causing ferroportin internalisation and degradation; this traps iron within macrophages (recycled from senescent RBCs) and reduces intestinal absorption, resulting in a low serum iron with high ferritin (iron sequestration). DMT-1 is on the apical membrane and is not the hepcidin target. TFR2 is an iron sensor.

Reference: Harper's Illustrated Biochemistry, 32nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.