About Erythroferrone


Erythroferrone (ERFE) Biology

Erythroferrone (ERFE) is a hormone produced by erythroblasts in the bone marrow in response to erythropoietin (EPO). By suppressing hepcidin expression in the liver, EFRE contributes to increased dietary iron absorption and recycling of stored iron necessary for recovery of blood mass after hemorrhage. In addition, ERFE is involved in hepcidin regulation in inherited iron loading anemias, such as β-Thalassemia. ERFE has potential as a clinical marker for assessing erythropoiesis in patients with blood disorders. 

The general physiological responses are:

  1. In response to anemia, EPO production by the kidneys causes the erythroblast population to expand in the bone marrow causing increased ERFE production by erythroblasts.
  2. Circulating ERFE directly acts on the liver to suppress hepcidin production, resulting in reduced hepcidin in the blood. Low levels of circulating hepcidin allow the release of stored iron from macrophages and hepatocytes into the bloodstream plus it increases dietary iron absorption.
  3. This process delivers more transferrin-bound iron to the developing erythroblasts, resulting in increased heme and hemoglobin synthesis

Adapted from R Coffey and T Ganz. Erythroferrone: An Erythroid Regulator of Hepcidin and Iron Metabolism.<br> Hemasphere. 2018 Mar-Apr; 2(2): e35.


• ERFE can predict mortality in patients with CKD and heart failure

• ERFE could be a therapeutic target for iron loading anemias

• ERFE levels may detect the abuse of erythropoiesis stimulating agents (ESAs) in the anti-doping field


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