PATHOGENESIS OF THE ANEMIA OF CHRONIC DISEASE - A CYTOKINE-MEDIATED ANEMIA

The anemia found in patients with chronic infectious, inflammatory and neoplastic disorders, known as the anemia of chronic disease (ACD), i s one of the most common syndromes in medicine. A characteristic findi ng of the disorders associated with ACD is increased production of the cytokines which mediate the immune or inflammatory response, such as tumor necrosis factor, interleukin 1 and the interferons. All the proc esses involved in the development of ACD can be attributed to these cy tokines, including shortened red cell survival, blunted erythropoietin response to anemia, impaired erythroid colony formation in response t o erythropoietin and abnormal mobilization of reticuloendothelial iron stores. Improved understanding of the role played by cytokines in the pathogenesis of ACD may lead to the development of more specific ther apy for this syndrome.