Figure 3.

Imbalance in hepcidin expression. Physiological hepcidin responses correlate with healthy body iron metabolism. Pathologically low hepcidin expression occurs in hereditary hemochromatosis (HH) and in iron-loading anemias; this leads to hyperferremia and parenchymal tissue iron overload due to increased iron efflux to the bloodstream from macrophages and intestinal enterocytes. Pathologically high hepcidin expression occurs in the anemia of chronic disease (ACD) and other anemias of iron-restricted erythropoiesis; this leads to hypoferremia and decreased iron availability for erythropoiesis due to iron sequestration in macrophages.