Anemia and impaired stress-induced erythropoiesis in aceruloplasminemic mice

Ceruloplasmin (Cp) is an abundant, copper-containing plasma protein with an important role in iron homeostasis. Patients with hereditary Cp deficiency have iron deposits in liver and other organs, consistent with impaired iron flux. The mild anemia reported in some patients suggests a possible role for Cp in iron delivery to red cell precursors during erythropoiesis. To investigate this function of Cp, we determined the hematologic parameters in Cp-deficient mice under normal conditions and after erythropoiesis-inducing stress. Cp−/− mice have below normal hematocrit, red cell hemoglobin and volume, and serum iron. Red cell number and turnover and reticulocyte counts were identical in Cp−/− and Cp+/+ mice. Thus, Cp−/− have mild microcytic, hypochromic anemia consistent with normal red cell formation but defective iron availability. Cp−/− and Cp+/+ mice subjected to phenylhydrazine-induced hemolytic anemia exhibited identical decreases in hematologic parameters, but Cp−/− mice showed diminished recovery after removal of the stress. Administration of purified human Cp or iron-saturated transferrin to Cp−/− mice partially restored hemoglobin formation in reticulocytes. The mild anemia in Cp−/− mice and the diminished response to stress may reflect inefficient recycling of iron between the reticuloendothelial and erythropoietic systems. Our findings suggest a role for Cp in erythropoiesis by providing sufficient iron to the erythroid tissue and that the requirement for Cp is raised after erythropoietic stress.