Hemophagocytosis causes a consumptive anemia of inflammation

EE Zoller, JE Lykens, CE Terrell, J Aliberti… - Journal of Experimental …, 2011 - rupress.org
EE Zoller, JE Lykens, CE Terrell, J Aliberti, AH Filipovich, PM Henson, MB Jordan
Journal of Experimental Medicine, 2011rupress.org
Cytopenias of uncertain etiology are commonly observed in patients during severe
inflammation. Hemophagocytosis, the histological appearance of blood-eating
macrophages, is seen in the disorder hemophagocytic lymphohistiocytosis and other
inflammatory contexts. Although it is hypothesized that these phenomena are linked, the
mechanisms facilitating acute inflammation-associated cytopenias are unknown. We report
that interferon γ (IFN-γ) is a critical driver of the acute anemia observed during diverse …
Cytopenias of uncertain etiology are commonly observed in patients during severe inflammation. Hemophagocytosis, the histological appearance of blood-eating macrophages, is seen in the disorder hemophagocytic lymphohistiocytosis and other inflammatory contexts. Although it is hypothesized that these phenomena are linked, the mechanisms facilitating acute inflammation-associated cytopenias are unknown. We report that interferon γ (IFN-γ) is a critical driver of the acute anemia observed during diverse microbial infections in mice. Furthermore, systemic exposure to physiologically relevant levels of IFN-γ is sufficient to cause acute cytopenias and hemophagocytosis. Demonstrating the significance of hemophagocytosis, we found that IFN-γ acts directly on macrophages in vivo to alter endocytosis and provoke blood cell uptake, leading to severe anemia. These findings define a unique pathological process of broad clinical and immunological significance, which we term the consumptive anemia of inflammation.
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