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Atkins LA, Spence AC, Szymlek-Gay EA. Iron Nutrition of Pre-Schoolers in High-Income Countries: A Review. Nutrients 2023; 15:nu15112616. [PMID: 37299582 DOI: 10.3390/nu15112616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
Pre-schoolers are vulnerable to iron deficiency, which, in high-resource countries, is mainly caused by suboptimal or poorly absorbable iron intakes. This review examines the prevalence of inadequate iron intakes and status, and the non-dietary factors associated with these, among children aged between 2 and 5 years within high-income countries. It then considers the quality of the pre-schooler diet in terms of dietary factors, dietary patterns, and iron intakes. Additionally, it discusses the assessment of iron bioavailability and examines the various methods used to estimate the amount of absorbable iron in pre-schooler diets. Knowledge of the adequacy of iron intakes and bioavailability of iron intakes, and dietary patterns associated with iron intakes can facilitate the design and implementation of effectively targeted community-based intervention studies to improve iron intakes and iron bioavailability to minimise the risk of iron deficiency.
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Affiliation(s)
- Linda A Atkins
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
| | - Alison C Spence
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
| | - Ewa A Szymlek-Gay
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
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2
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Clinical and Molecular Aspects of Iron Metabolism in Failing Myocytes. LIFE (BASEL, SWITZERLAND) 2022; 12:life12081203. [PMID: 36013382 PMCID: PMC9409945 DOI: 10.3390/life12081203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/15/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022]
Abstract
Heart failure (HF) is a common disease that causes significant limitations on the organism's capacity and, in extreme cases, leads to death. Clinically, iron deficiency (ID) plays an essential role in heart failure by deteriorating the patient's condition and is a prognostic marker indicating poor clinical outcomes. Therefore, in HF patients, supplementation of iron is recommended. However, iron treatment may cause adverse effects by increasing iron-related apoptosis and the production of oxygen radicals, which may cause additional heart damage. Furthermore, many knowledge gaps exist regarding the complex interplay between iron deficiency and heart failure. Here, we describe the current, comprehensive knowledge about the role of the proteins involved in iron metabolism. We will focus on the molecular and clinical aspects of iron deficiency in HF. We believe that summarizing the new advances in the translational and clinical research regarding iron deficiency in heart failure should broaden clinicians' awareness of this comorbidity.
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Firth G, Blower JE, Bartnicka JJ, Mishra A, Michaels AM, Rigby A, Darwesh A, Al-Salemee F, Blower PJ. Non-invasive radionuclide imaging of trace metal trafficking in health and disease: "PET metallomics". RSC Chem Biol 2022; 3:495-518. [PMID: 35656481 PMCID: PMC9092424 DOI: 10.1039/d2cb00033d] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/07/2022] [Indexed: 12/05/2022] Open
Abstract
Several specific metallic elements must be present in the human body to maintain health and function. Maintaining the correct quantity (from trace to bulk) and location at the cell and tissue level is essential. The study of the biological role of metals has become known as metallomics. While quantities of metals in cells and tissues can be readily measured in biopsy and autopsy samples by destructive analytical techniques, their trafficking and its role in health and disease are poorly understood. Molecular imaging with radionuclides - positron emission tomography (PET) and single photon emission computed tomography (SPECT) - is emerging as a means to non-invasively study the acute trafficking of essential metals between organs, non-invasively and in real time, in health and disease. PET scanners are increasingly widely available in hospitals, and methods for producing radionuclides of some of the key essential metals are developing fast. This review summarises recent developments in radionuclide imaging technology that permit such investigations, describes the radiological and physicochemical properties of key radioisotopes of essential trace metals and useful analogues, and introduces current and potential future applications in preclinical and clinical investigations to study the biology of essential trace metals in health and disease.
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Affiliation(s)
- George Firth
- School of Biomedical Engineering & Imaging Sciences, King's College London, St. Thomas' Hospital London UK
| | - Julia E Blower
- School of Biomedical Engineering & Imaging Sciences, King's College London, St. Thomas' Hospital London UK
| | - Joanna J Bartnicka
- School of Biomedical Engineering & Imaging Sciences, King's College London, St. Thomas' Hospital London UK
| | - Aishwarya Mishra
- School of Biomedical Engineering & Imaging Sciences, King's College London, St. Thomas' Hospital London UK
| | - Aidan M Michaels
- School of Biomedical Engineering & Imaging Sciences, King's College London, St. Thomas' Hospital London UK
| | - Alex Rigby
- School of Biomedical Engineering & Imaging Sciences, King's College London, St. Thomas' Hospital London UK
| | - Afnan Darwesh
- School of Biomedical Engineering & Imaging Sciences, King's College London, St. Thomas' Hospital London UK
| | - Fahad Al-Salemee
- School of Biomedical Engineering & Imaging Sciences, King's College London, St. Thomas' Hospital London UK
| | - Philip J Blower
- School of Biomedical Engineering & Imaging Sciences, King's College London, St. Thomas' Hospital London UK
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Wu A, Feng B, Yu J, Yan L, Che L, Zhuo Y, Luo Y, Yu B, Wu D, Chen D. Fibroblast growth factor 21 attenuates iron overload-induced liver injury and fibrosis by inhibiting ferroptosis. Redox Biol 2021; 46:102131. [PMID: 34530349 PMCID: PMC8445902 DOI: 10.1016/j.redox.2021.102131] [Citation(s) in RCA: 110] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/28/2021] [Accepted: 09/09/2021] [Indexed: 01/01/2023] Open
Abstract
Ferroptosis plays a role in several diseases such as iron overload-induced liver diseases. Manipulation of ferroptosis has been explored as a potential therapeutic strategy to treat related diseases. Numerous antioxidants have been identified to control ferroptosis but the cell-autonomous mechanisms responsible for regulating ferroptosis remain elusive. In the present study, we found that iron overload promoted ferroptosis in hepatocytes by excessively inducing HO-1 expression, which contributed to the progression of liver injury and fibrosis, accompanied by the upregulation of the FGF21 protein level in vitro and in vivo. Interestingly, both recombinant FGF21 and Fgf21 overexpression significantly protected against iron overload-induced hepatocytes mitochondria damage, liver injury and fibrosis by inhibiting ferroptosis. In contrast, the loss of FGF21 aggravated iron overload-induced ferroptosis. Notably, FGF21-induced HO-1 inhibition (via the promotion of HO-1 ubiquitination and degradation) and NRF2 activation provide a mechanistic explanation for this phenomenon. Taken together, we identified FGF21 as a novel ferroptosis suppressor. Thus, FGF21 activation may provide an effective strategy for the potential treatment of iron overload-induced ferroptosis-related diseases, such as hereditary haemochromatosis (HH). Iron overload robustly induces hepatic FGF21 expression both in vitro and in vivo. FGF21 suppresses iron overload-induced hepatocytes ferroptosis. Constitutive HO-1 activation contributes to iron overload-induced ferroptosis in hepatocytes. FGF21 protects hepatocytes from iron overload-induced ferroptosis by stimulating HO-1 ubiquitination and degradation.
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Affiliation(s)
- Aimin Wu
- Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, China; Key Laboratory for Animal Disease-resistance Nutrition of China Ministry of Education, Sichuan Agricultural University, Chengdu, China
| | - Bin Feng
- Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, China
| | - Jie Yu
- Key Laboratory for Animal Disease-resistance Nutrition of China Ministry of Education, Sichuan Agricultural University, Chengdu, China
| | - Lijun Yan
- Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, China
| | - Lianqiang Che
- Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, China
| | - Yong Zhuo
- Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, China
| | - Yuheng Luo
- Key Laboratory for Animal Disease-resistance Nutrition of China Ministry of Education, Sichuan Agricultural University, Chengdu, China
| | - Bing Yu
- Key Laboratory for Animal Disease-resistance Nutrition of China Ministry of Education, Sichuan Agricultural University, Chengdu, China.
| | - De Wu
- Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, China.
| | - Daiwen Chen
- Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, China; Key Laboratory for Animal Disease-resistance Nutrition of China Ministry of Education, Sichuan Agricultural University, Chengdu, China.
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Atkins LA, McNaughton SA, Spence AC, Szymlek-Gay EA. Dietary patterns of Australian pre-schoolers and associations with haem and non-haem iron intakes. Eur J Nutr 2021; 60:3059-3070. [PMID: 33484317 DOI: 10.1007/s00394-020-02477-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/21/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To describe Australian pre-schooler dietary patterns and examine their associations with dietary iron intakes. METHODS Dietary data of children (n = 812, 2 to < 6 years old) from the 2011-12 National Nutrition and Physical Activity Survey were collected via two non-consecutive 24-h recalls and analysed using AUSNUT 2011-13. Usual food and nutrient intakes were estimated via Multiple Source Method. Principal component analysis was used to extract dietary patterns from 32 food groups. Associations between dietary patterns and energy-adjusted iron intakes were assessed using linear regression, accounting for the complex survey design. RESULTS Mean (SD) usual total dietary and haem iron intakes were 6.3 (1.9) and 0.5 (0.3) mg/day, respectively. Three dietary patterns were identified, explaining 14% of the variance. Pattern 1 (positive loadings for cheese, breads, fats and oils, and water) was positively associated with total dietary iron intakes (β = 0.08, 95% CI 0.01, 0.15). Pattern 3 (positive loadings for red meat, fortified fruit and vegetable products, and sauces and spreads) was negatively associated with total dietary iron (β = - 0.08, 95% CI - 0.14, - 0.01) and non-haem iron (β = - 0.09, 95% CI - 0.15, - 0.02) intakes. No dietary patterns were associated with haem iron intakes. CONCLUSIONS Three main patterns characterise Australian pre-schooler diets. The pattern with which dietary iron is positively associated is predominately characterised by non-haem iron sources and non-iron-fortified foods. Future research is required to estimate the iron bioavailability of Australian pre-schooler diets.
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Affiliation(s)
- Linda A Atkins
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Alison C Spence
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Ewa A Szymlek-Gay
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
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Lewis FW, Fairooz S, Elson JL, Hubscher-Bruder V, Brandel J, Soundararajan M, Smith D, Dexter DT, Tétard D, Pienaar IS. Novel 1-hydroxypyridin-2-one metal chelators prevent and rescue ubiquitin proteasomal-related neuronal injury in an in vitro model of Parkinson's disease. Arch Toxicol 2020; 94:813-831. [PMID: 32078022 DOI: 10.1007/s00204-020-02672-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 02/11/2020] [Indexed: 02/06/2023]
Abstract
Ubiquitin proteasome system (UPS) impairment, excessive cellular oxidative stress, and iron dyshomeostasis are key to substantia nigra dopaminergic neuronal degeneration in Parkinson's disease (PD); however, a link between these features remains unconfirmed. Using the proteasome inhibitor lactacystin we confirm that nigral injury via UPS impairment disrupts iron homeostasis, in turn increasing oxidative stress and promoting protein aggregation. We demonstrate the neuroprotective potential of two novel 1-hydroxy-2(1H)-pyridinone (1,2-HOPO) iron chelators, compounds C6 and C9, against lactacystin-induced cell death. We demonstrate that this cellular preservation relates to the compounds' iron chelating capabilities and subsequent reduced capacity of iron to form reactive oxygen species (ROS), where we also show that the ligands act as antioxidant agents. Our results also demonstrate the ability of C6 and C9 to reduce intracellular lactacystin-induced α-synuclein burden. Stability constant measurements confirmed a high affinity of C6 and C9 for Fe3+ and display a 3:1 HOPO:Fe3+ complex formation at physiological pH. Reducing iron reactivity could prevent the demise of nigral dopaminergic neurons. We provide evidence that the lactacystin model presents with several neuropathological hallmarks of PD related to iron dyshomeostasis and that the novel chelating compounds C6 and C9 can protect against lactacystin-related neurotoxicity.
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Affiliation(s)
- Frank W Lewis
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Safiya Fairooz
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Joanna L Elson
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, NE1 3BZ, UK
| | - Véronique Hubscher-Bruder
- Hubert Curien Pluridisciplinary Institute (IPHC), Université de Strasbourg, 67087, Strasbourg, France
| | - Jeremy Brandel
- Hubert Curien Pluridisciplinary Institute (IPHC), Université de Strasbourg, 67087, Strasbourg, France
| | - Meera Soundararajan
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - David Smith
- Department of Biosciences and Chemistry, Sheffield Hallam University, Sheffield, UK
| | - David T Dexter
- Centre for Neuroinflammation and Neurodegeneration, Faculty of Medicine, Imperial College London, London, W12 ONN, UK
| | - David Tétard
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK.
| | - Ilse S Pienaar
- School of Life Sciences, University of Sussex, Falmer, BN1 9PH, UK.
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Qian ZM, Ke Y. Hepcidin and its therapeutic potential in neurodegenerative disorders. Med Res Rev 2019; 40:633-653. [PMID: 31471929 DOI: 10.1002/med.21631] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/18/2019] [Accepted: 08/05/2019] [Indexed: 12/12/2022]
Abstract
Abnormally high brain iron, resulting from the disrupted expression or function of proteins involved in iron metabolism in the brain, is an initial cause of neuronal death in neuroferritinopathy and aceruloplasminemia, and also plays a causative role in at least some of the other neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, Huntington's disease, and Friedreich's ataxia. As such, iron is believed to be a novel target for pharmacological intervention in these disorders. Reducing iron toward normal levels or hampering the increases in iron associated with age in the brain is a promising therapeutic strategy for all iron-related neurodegenerative disorders. Hepcidin is a crucial regulator of iron homeostasis in the brain. Recent studies have suggested that upregulating brain hepcidin levels can significantly reduce brain iron content through the regulation of iron transport protein expression in the blood-brain barrier and in neurons and astrocytes. In this review, we focus on the discussion of the therapeutic potential of hepcidin in iron-associated neurodegenerative diseases and also provide a systematic overview of recent research progress on how misregulated brain iron metabolism is involved in the development of multiple neurodegenerative disorders.
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Affiliation(s)
- Zhong-Ming Qian
- Institute of Translational & Precision Medicine, Nantong University, Nantong, Jiangsu, China.,Laboratory of Neuropharmacology, School of Pharmacy & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ya Ke
- School of Biomedical Sciences and Gerald Choa Neuroscience Centre, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, China
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8
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The Functional Versatility of Transferrin Receptor 2 and Its Therapeutic Value. Pharmaceuticals (Basel) 2018; 11:ph11040115. [PMID: 30360575 PMCID: PMC6316356 DOI: 10.3390/ph11040115] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 10/19/2018] [Accepted: 10/21/2018] [Indexed: 12/11/2022] Open
Abstract
Iron homeostasis is a tightly regulated process in all living organisms because this metal is essential for cellular metabolism, but could be extremely toxic when present in excess. In mammals, there is a complex pathway devoted to iron regulation, whose key protein is hepcidin (Hepc), which is a powerful iron absorption inhibitor mainly produced by the liver. Transferrin receptor 2 (Tfr2) is one of the hepcidin regulators, and mutations in TFR2 gene are responsible for type 3 hereditary hemochromatosis (HFE3), a genetically heterogeneous disease characterized by systemic iron overload. It has been recently pointed out that Hepc production and iron regulation could be exerted also in tissues other than liver, and that Tfr2 has an extrahepatic role in iron metabolism as well. This review summarizes all the most recent data on Tfr2 extrahepatic role, taking into account the putative distinct roles of the two main Tfr2 isoforms, Tfr2α and Tfr2β. Representing Hepc modulation an effective approach to correct iron balance impairment in common human diseases, and with Tfr2 being one of its regulators, it would be worthwhile to envisage Tfr2 as a therapeutic target.
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Dziegala M, Josiak K, Kasztura M, Kobak K, von Haehling S, Banasiak W, Anker SD, Ponikowski P, Jankowska E. Iron deficiency as energetic insult to skeletal muscle in chronic diseases. J Cachexia Sarcopenia Muscle 2018; 9:802-815. [PMID: 30178922 PMCID: PMC6204587 DOI: 10.1002/jcsm.12314] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 04/05/2018] [Accepted: 04/22/2018] [Indexed: 12/19/2022] Open
Abstract
Specific skeletal myopathy constitutes a common feature of heart failure, chronic obstructive pulmonary disease, and type 2 diabetes mellitus, where it can be characterized by the loss of skeletal muscle oxidative capacity. There is evidence from in vitro and animal studies that iron deficiency affects skeletal muscle functioning mainly in the context of its energetics by limiting oxidative metabolism in favour of glycolysis and by alterations in both carbohydrate and fat catabolic processing. In this review, we depict the possible molecular pathomechanisms of skeletal muscle energetic impairment and postulate iron deficiency as an important factor causally linked to loss of muscle oxidative capacity that contributes to skeletal myopathy seen in patients with heart failure, chronic obstructive pulmonary disease, and type 2 diabetes mellitus.
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Affiliation(s)
- Magdalena Dziegala
- Laboratory for Applied Research on Cardiovascular System, Department of Heart DiseasesWroclaw Medical University50‐981WroclawPoland
| | - Krystian Josiak
- Centre for Heart DiseasesMilitary Hospital50‐981WroclawPoland
- Department of Heart DiseasesWroclaw Medical University50‐367WroclawPoland
| | - Monika Kasztura
- Laboratory for Applied Research on Cardiovascular System, Department of Heart DiseasesWroclaw Medical University50‐981WroclawPoland
| | - Kamil Kobak
- Laboratory for Applied Research on Cardiovascular System, Department of Heart DiseasesWroclaw Medical University50‐981WroclawPoland
| | - Stephan von Haehling
- Department of Cardiology and PneumologyUniversity Medicine Göttingen (UMG)37075GöttingenGermany
| | | | - Stefan D. Anker
- Department of Cardiology and PneumologyUniversity Medicine Göttingen (UMG)37075GöttingenGermany
- Division of Cardiology and MetabolismCharité Universitätsmedizin10117BerlinGermany
- Department of Cardiology (CVK)Charité Universitätsmedizin10117BerlinGermany
- Berlin‐Brandenburg Center for Regenerative Therapies (BCRT)Charité Universitätsmedizin10117BerlinGermany
- German Centre for Cardiovascular Research (DZHK) partner site BerlinCharité Universitätsmedizin10117BerlinGermany
| | - Piotr Ponikowski
- Centre for Heart DiseasesMilitary Hospital50‐981WroclawPoland
- Department of Heart DiseasesWroclaw Medical University50‐367WroclawPoland
| | - Ewa Jankowska
- Laboratory for Applied Research on Cardiovascular System, Department of Heart DiseasesWroclaw Medical University50‐981WroclawPoland
- Centre for Heart DiseasesMilitary Hospital50‐981WroclawPoland
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10
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Ramakrishnan L, Pedersen SL, Toe QK, West LE, Mumby S, Casbolt H, Issitt T, Garfield B, Lawrie A, Wort SJ, Quinlan GJ. The Hepcidin/Ferroportin axis modulates proliferation of pulmonary artery smooth muscle cells. Sci Rep 2018; 8:12972. [PMID: 30154413 PMCID: PMC6113242 DOI: 10.1038/s41598-018-31095-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 08/10/2018] [Indexed: 12/22/2022] Open
Abstract
Studies were undertaken to examine any role for the hepcidin/ferroportin axis in proliferative responses of human pulmonary artery smooth muscle cells (hPASMCs). Entirely novel findings have demonstrated the presence of ferroportin in hPASMCs. Hepcidin treatment caused increased proliferation of these cells most likely by binding ferroportin resulting in internalisation and cellular iron retention. Cellular iron content increased with hepcidin treatment. Stabilisation of ferroportin expression and activity via intervention with the therapeutic monoclonal antibody LY2928057 reversed proliferation and cellular iron accumulation. Additionally, IL-6 treatment was found to enhance proliferation and iron accumulation in hPASMCs; intervention with LY2928057 prevented this response. IL-6 was also found to increase hepcidin transcription and release from hPASMCs suggesting a potential autocrine response. Hepcidin or IL-6 mediated iron accumulation contributes to proliferation in hPASMCs; ferroportin mediated cellular iron excretion limits proliferation. Haemoglobin also caused proliferation of hPASMCs; in other novel findings, CD163, the haemoglobin/haptoglobin receptor, was found on these cells and offers a means for cellular uptake of iron via haemoglobin. Il-6 was also found to modulate CD163 on these cells. These data contribute to a better understanding of how disrupted iron homeostasis may induce vascular remodelling, such as in pulmonary arterial hypertension.
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MESH Headings
- Antibodies, Monoclonal/pharmacology
- Antigens, CD/metabolism
- Antigens, Differentiation, Myelomonocytic/metabolism
- Autocrine Communication/drug effects
- Autocrine Communication/physiology
- Cation Transport Proteins/biosynthesis
- Cell Proliferation
- Cells, Cultured
- Gene Expression Regulation/drug effects
- Gene Expression Regulation/physiology
- Hepcidins/biosynthesis
- Humans
- Interleukin-6/metabolism
- Iron/metabolism
- Muscle, Smooth, Vascular/cytology
- Muscle, Smooth, Vascular/metabolism
- Myocytes, Smooth Muscle/cytology
- Myocytes, Smooth Muscle/metabolism
- Pulmonary Artery/cytology
- Pulmonary Artery/metabolism
- Receptors, Cell Surface/metabolism
- Transcription, Genetic/drug effects
- Transcription, Genetic/physiology
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Affiliation(s)
- Latha Ramakrishnan
- Vascular Biology Group, National Heart and Lung Institute, Imperial College London, Faculty of Medicine, Guy Scadding Building, London, SW3 6LY, UK
| | - Sofia L Pedersen
- Vascular Biology Group, National Heart and Lung Institute, Imperial College London, Faculty of Medicine, Guy Scadding Building, London, SW3 6LY, UK
| | - Quezia K Toe
- Vascular Biology Group, National Heart and Lung Institute, Imperial College London, Faculty of Medicine, Guy Scadding Building, London, SW3 6LY, UK
| | - Laura E West
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, S10 2RX, Sheffield, UK
| | - Sharon Mumby
- Vascular Biology Group, National Heart and Lung Institute, Imperial College London, Faculty of Medicine, Guy Scadding Building, London, SW3 6LY, UK
| | - Helen Casbolt
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, S10 2RX, Sheffield, UK
| | - Theo Issitt
- Vascular Biology Group, National Heart and Lung Institute, Imperial College London, Faculty of Medicine, Guy Scadding Building, London, SW3 6LY, UK
| | - Benjamin Garfield
- Vascular Biology Group, National Heart and Lung Institute, Imperial College London, Faculty of Medicine, Guy Scadding Building, London, SW3 6LY, UK
| | - Allan Lawrie
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, S10 2RX, Sheffield, UK
| | - S John Wort
- Vascular Biology Group, National Heart and Lung Institute, Imperial College London, Faculty of Medicine, Guy Scadding Building, London, SW3 6LY, UK
| | - Gregory J Quinlan
- Vascular Biology Group, National Heart and Lung Institute, Imperial College London, Faculty of Medicine, Guy Scadding Building, London, SW3 6LY, UK.
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11
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Wittkamp C, Traeger L, Ellermann I, Eveslage M, Steinbicker AU. Hepcidin as a potential predictor for preoperative anemia treatment with intravenous iron-A retrospective pilot study. PLoS One 2018; 13:e0201153. [PMID: 30089125 PMCID: PMC6082514 DOI: 10.1371/journal.pone.0201153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 07/08/2018] [Indexed: 12/14/2022] Open
Abstract
Preoperative anemia occurs in about one third of patients who undergo elective surgery and is associated with an impaired outcome. Therefore, screening of preoperative anemia was established in the context of a multidisciplinary Patient Blood Management (PBM) program at the University Hospital of Muenster, Germany. Anemic patients without contraindications were treated with intravenous (IV) iron (ferric carboxymaltose) to increase their hemoglobin (Hgb) levels and hence to treat anemia prior to surgery. Interestingly, we detected a large variability in the response of Hgb levels after IV iron administration. Systemic iron homeostasis is mainly regulated by the hepatic hormone hepcidin, which regulates the cell surface expression of the sole known iron exporter ferroportin. The objective of this retrospective pilot study was to analyze the potential of hepcidin to predict the response of anemic patients to preoperative IV iron treatment measured as increase in Hgb. Serum samples of non-anemic (n = 48), untreated anemic (n = 64) and anemic patients treated with IV iron (n = 79), in total 191 patients, were collected between October 2014 until June 2016. Serum hepcidin levels were determined and data were analyzed retrospectively. The analysis revealed at first a correlation between serum hepcidin levels and the parameters of the iron status. Second, patients treated with IV iron showed a noticeably higher increase in their delta Hgb level between PBM consultation and surgery (0.45g/dl [0.05, 1.05] compared to patients without IV iron (0.1g/dl [-0.48, 0.73], *p = 0.03). Patients were then grouped into ‘non-responders’, defined as delta Hgb <0.6g/dl and ‘responders’, with delta Hgb ≥0.6g/dl between the day of IV iron treatment and the day of surgery. Within normal ranges and clinically unapparent, a statistically noticeable difference between responders and non-responders was found for CRP and leukocytes. Serum hepcidin levels were higher in the group of non-responders (10.6ng/ml [3.93, 34.77]) compared to responders (2.1ng/ml [0.25, 7.97], *p = 0.04). To conclude, the data of this retrospective pilot study indicate that hepcidin might be a promising biomarker to predict a patient`s responsiveness to IV iron in preoperative anemia treatment. Prospective studies have to investigate serum hepcidin levels as a biomarker to guide physician`s decision on IV iron substitution.
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Affiliation(s)
- Christina Wittkamp
- Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, University of Muenster, Muenster, Germany
| | - Lisa Traeger
- Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, University of Muenster, Muenster, Germany
| | - Ines Ellermann
- Department of Pharmacy, University Hospital Muenster, University of Muenster, Muenster, Germany
| | - Maria Eveslage
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Andrea U. Steinbicker
- Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, University of Muenster, Muenster, Germany
- * E-mail:
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12
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Fourie R, Kuloyo OO, Mochochoko BM, Albertyn J, Pohl CH. Iron at the Centre of Candida albicans Interactions. Front Cell Infect Microbiol 2018; 8:185. [PMID: 29922600 PMCID: PMC5996042 DOI: 10.3389/fcimb.2018.00185] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 05/14/2018] [Indexed: 12/27/2022] Open
Abstract
Iron is an absolute requirement for both the host and most pathogens alike and is needed for normal cellular growth. The acquisition of iron by biological systems is regulated to circumvent toxicity of iron overload, as well as the growth deficits imposed by iron deficiency. In addition, hosts, such as humans, need to limit the availability of iron to pathogens. However, opportunistic pathogens such as Candida albicans are able to adapt to extremes of iron availability, such as the iron replete environment of the gastrointestinal tract and iron deficiency during systemic infection. C. albicans has developed a complex and effective regulatory circuit for iron acquisition and storage to circumvent iron limitation within the human host. As C. albicans can form complex interactions with both commensal and pathogenic co-inhabitants, it can be speculated that iron may play an important role in these interactions. In this review, we highlight host iron regulation as well as regulation of iron homeostasis in C. albicans. In addition, the review argues for the need for further research into the role of iron in polymicrobial interactions. Lastly, the role of iron in treatment of C. albicans infection is discussed.
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Affiliation(s)
- Ruan Fourie
- Pathogenic Yeast Research Group, Department of Microbial, Biochemical and Food Biotechnology, University of the Free State, Bloemfontein, South Africa
| | - Oluwasegun O Kuloyo
- Pathogenic Yeast Research Group, Department of Microbial, Biochemical and Food Biotechnology, University of the Free State, Bloemfontein, South Africa
| | - Bonang M Mochochoko
- Pathogenic Yeast Research Group, Department of Microbial, Biochemical and Food Biotechnology, University of the Free State, Bloemfontein, South Africa
| | - Jacobus Albertyn
- Pathogenic Yeast Research Group, Department of Microbial, Biochemical and Food Biotechnology, University of the Free State, Bloemfontein, South Africa
| | - Carolina H Pohl
- Pathogenic Yeast Research Group, Department of Microbial, Biochemical and Food Biotechnology, University of the Free State, Bloemfontein, South Africa
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Ramakrishnan L, Pedersen SL, Toe QK, Quinlan GJ, Wort SJ. Pulmonary Arterial Hypertension: Iron Matters. Front Physiol 2018; 9:641. [PMID: 29904352 PMCID: PMC5990599 DOI: 10.3389/fphys.2018.00641] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/11/2018] [Indexed: 12/16/2022] Open
Abstract
The interplay between iron and oxygen is longstanding and central to all aerobic life. Tight regulation of these interactions including homeostatic regulation of iron utilization ensures safe usage of this limited resource. However, when control is lost adverse events can ensue, which are known to contribute to an array of disease processes. Recently, associations between disrupted iron homeostasis and pulmonary artery hypertension (PAH) have been described with the suggestion that there is a contributory link with disease. This review provides a background for iron regulation in humans, describes PAH classifications, and discusses emerging literature, which suggests a role for disrupted iron homeostatic control in various sub-types of PAH, including a role for decompartmentalization of hemoglobin. Finally, the potential for therapeutic options to restore iron homeostatic balance in PAH are discussed.
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Unraveling the Burden of Iron in Neurodegeneration: Intersections with Amyloid Beta Peptide Pathology. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:2850341. [PMID: 29581821 PMCID: PMC5831758 DOI: 10.1155/2018/2850341] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 12/17/2017] [Indexed: 12/14/2022]
Abstract
Iron overload is a hallmark of many neurodegenerative processes such as Alzheimer's, Parkinson's, and Huntington's diseases. Unbound iron accumulated as a consequence of brain aging is highly reactive with water and oxygen and produces reactive oxygen species (ROS) or free radicals. ROS are toxic compounds able to damage cell membranes, DNA, and mitochondria. Which are the mechanisms involved in neuronal iron homeostasis and in neuronal response to iron-induced oxidative stress constitutes a cutting-edge topic in metalloneurobiology. Increasing our knowledge about the underlying mechanisms that operate in iron accumulation and their consequences would shed light on the comprehension of the molecular events that participate in the pathophysiology of the abovementioned neurodegenerative diseases. In this review, current evidences about iron accumulation in the brain, the signaling mechanisms triggered by metal overload, as well as the interaction between amyloid β (Aβ) and iron, will be summarized.
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Eidlitz-Markus T, Zolden S, Haimi-Cohen Y, Zeharia A. Comparison of comorbidities of migraine and tension headache in a pediatric headache clinic. Cephalalgia 2016; 37:1135-1144. [PMID: 27586882 DOI: 10.1177/0333102416665870] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Objective To compare comorbidities between migraine and tension headache in patients treated in a tertiary pediatric headache clinic. Methods Files of patients with migraine or tension headache attending a pediatric headache clinic were retrospectively reviewed for the presence of organic comorbidities. Additionally, patients were screened with the self-report Strengths and Difficulties Questionnaire to identify nonorganic comorbidities. If necessary, patients were referred to a pediatric psychiatrist, psychologist or social worker for further evaluation. Results The study cohort comprised 401 patients: 200 with migraine and 201 with tension headache. The main organic comorbidities were atopic disease, asthma, and first-reported iron-deficiency anemia; all occurred with statistical significance more often with migraine than with tension headache (Familial Mediterranean fever was six times more frequent in the migraine group than in the tension headache group, but the difference was not statistically significant. Nonorganic comorbidities (psychiatric, social stressors) were associated significantly more often with tension headache than with migraine (48.3% versus 33%; p = 0.03). Conclusions Children and adolescents with migraine or tension headache treated in a dedicated clinic have high rates of organic and nonorganic comorbidities. In this setting, patients with migraine have significantly more organic comorbidities, and patients with tension headache, significantly more nonorganic comorbidities.
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Affiliation(s)
- Tal Eidlitz-Markus
- 1 Pediatric Headache Clinic, Day Hospitalization Department, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shirit Zolden
- 1 Pediatric Headache Clinic, Day Hospitalization Department, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yishai Haimi-Cohen
- 1 Pediatric Headache Clinic, Day Hospitalization Department, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Avraham Zeharia
- 1 Pediatric Headache Clinic, Day Hospitalization Department, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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The impact of H63D HFE gene carriage on hemoglobin and iron status in children. Ann Hematol 2016; 95:2043-2048. [PMID: 27553379 PMCID: PMC5093215 DOI: 10.1007/s00277-016-2792-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 08/05/2016] [Indexed: 12/20/2022]
Abstract
The molecular mechanism that regulates iron homeostasis is based on a network of signals, which reflect on the iron requirements of the body. Hereditary hemochromatosis is a heterogenic metabolic syndrome which is due to unchecked transfer of iron into the bloodstream and its toxic effects on parenchymatous organs. It is caused by the mutation of genes that encode proteins that help hepcidin to monitor serum iron. These proteins include the human hemochromatosis protein -HFE, transferrin-receptor 2, hemojuvelin in rare instances, and ferroportin. HFE-related hemochromatosis is the most frequent form of the disease. Interestingly, the low penetrance of polymorphic HFE genes results in rare clinical presentation of the disease, predominantly in middle-aged males. Taking into account the wide dispersion of HFE mutation in our population and also its unknown role in heterozygotes, we analyzed the impact of H63D HFE carriage in the developmental age, with respect to gender, on the iron status and hemoglobin concentration of carriers in comparison to those of wild-type HFE gene (12.7 ± 3.07 years, 42 boys and 41 girls). H63D carriers presented higher blood iron, transferrin saturation, and ferritin concentration than wild-type probands (p < 0.05.) Interestingly, male H63D carriers showed higher hemoglobin concentration than the unburdened children. Moreover, in the H63D carrier group, a positive correlation between iron and hemoglobin was noted. In conclusion, this study demonstrates that changes in iron metabolism occur at a young age in HFE heterozygotes.
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Shu XB, Zhang L, Huang J, Ji G. Relationship between iron overload and nonalcoholic fatty liver disease: An update. Shijie Huaren Xiaohua Zazhi 2016; 24:3398-3403. [DOI: 10.11569/wcjd.v24.i22.3398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
As a component of the multiple hits, iron overload plays an important role in the development of nonalcoholic fatty liver disease (NAFLD). Iron overload could affect glucose, lipid, energy metabolism and inflammatory reaction. This paper reviews the relationship between iron overload and nonalcoholic fatty liver disease, in order to clarify how and why iron overload influences the progression of NAFLD.
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EPO-dependent induction of erythroferrone drives hepcidin suppression and systematic iron absorption under phenylhydrazine-induced hemolytic anemia. Blood Cells Mol Dis 2016; 58:45-51. [PMID: 27067488 DOI: 10.1016/j.bcmd.2016.02.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/16/2016] [Accepted: 02/17/2016] [Indexed: 02/07/2023]
Abstract
Hemolytic anemia is a common form of anemia due to hemolysis, resulting in disordered iron homeostasis. In this study, a dose of 40mg/kg phenylhydrazine (PHZ) was injected into mice to successfully establish a pronounced anemia animal model, which resulted in stress erythropoiesis and iron absorption. We found that serum erythropoietin (EPO) concentration was dramatically elevated by nearly 5000-fold for the first 2days, and then drop to the basal level on day 6 after PHZ injection. Mirrored with serum EPO concentration, the mRNA expression of erythroferrone (ERFE) was rapidly increased in the bone marrow and spleen 3days after injection of PHZ, and then gradually decreased but was still higher than baseline on day 6. In addition, we also found that the hepcidin mRNA levels were gradually reduced almost up to 8-fold on day 5, and then was ameliorated compared to the untreated control. Mechanistic investigation manifested that the increase of serum EPO essentially determined the induction of ERFE expression particular at the first 3days after PHZ treatment. Lentiviral mediated ERFE knockdown significantly restrained hepcidin suppression under PHZ treatment. Thus, our data unearthed EPO-dependent ERFE expression acts as an erythropoiesis-driven regulator of iron metabolism under PHZ-induced hemolytic anemia.
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Stugiewicz M, Tkaczyszyn M, Kasztura M, Banasiak W, Ponikowski P, Jankowska EA. The influence of iron deficiency on the functioning of skeletal muscles: experimental evidence and clinical implications. Eur J Heart Fail 2016; 18:762-73. [PMID: 26800032 DOI: 10.1002/ejhf.467] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 10/16/2015] [Accepted: 10/22/2015] [Indexed: 12/26/2022] Open
Abstract
Skeletal and respiratory myopathy not only constitutes an important pathophysiological feature of heart failure and chronic obstructive pulmonary disease, but also contributes to debilitating symptomatology and predicts worse outcomes in these patients. Accumulated evidence from laboratory experiments, animal models, and interventional studies in sports medicine suggests that undisturbed systemic iron homeostasis significantly contributes to the effective functioning of skeletal muscles. In this review, we discuss the role of iron status for the functioning of skeletal muscle tissue, and highlight iron deficiency as an emerging therapeutic target in chronic diseases accompanied by a marked muscle dysfunction.
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Affiliation(s)
- Magdalena Stugiewicz
- Students' Scientific Association, Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Michał Tkaczyszyn
- Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.,Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland
| | - Monika Kasztura
- Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Waldemar Banasiak
- Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland
| | - Piotr Ponikowski
- Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.,Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Ewa A Jankowska
- Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.,Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland
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Bonomini M, Del Vecchio L, Sirolli V, Locatelli F. New Treatment Approaches for the Anemia of CKD. Am J Kidney Dis 2016; 67:133-42. [DOI: 10.1053/j.ajkd.2015.06.030] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 06/29/2015] [Indexed: 12/20/2022]
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21
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Parker ME, Mosites E, Reider K, Ndayishimiye N, Waring M, Nyandimbane G, Masumbuko D, Ndikuriyo L, Matthias D. A Blinded, Cluster-Randomized, Placebo-Controlled School FeedingTrial in Burundi Using Rice Fortified With Iron, Zinc, Thiamine, and Folic Acid. Food Nutr Bull 2015; 36:481-92. [PMID: 26612421 DOI: 10.1177/0379572115615234] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Iron-deficiency anemia is a major public health problem among school-aged children in sub-Saharan Africa. OBJECTIVE To evaluate the effectiveness of micronutrient-fortified rice to increase hemoglobin (Hb) concentration and reduce the prevalence of anemia among schoolchildren. METHODS Nine hundred four schoolchildren participated in this cluster-randomized trial during a 7-month intervention period. The study was conducted in 12 primary schools in rural Burundi. Hemoglobin, socioeconomic status, febrile illness, and dietary diversity were measured at baseline and follow-up. The changes in Hb concentration and anemia status were analyzed using linear and logistic mixed models, respectively. The micronutrient formulation contained an iron-to-zinc molar ratio of approximately 2.2. RESULTS There was no significant difference in Hb concentration between the intervention and control groups (β = .09 g/dL; 95% confidence interval: -0.21 to 0.38) following the 7-month intervention. Nearly half the children reported having a fever within 2 weeks prior to baseline or follow-up. Children with febrile illness preceding follow-up were less than half as likely to show improvement in anemia status (odds ratio = 0.47, P < .001), with an average 0.56 g/dL smaller improvement in Hb at follow-up (P < .001). CONCLUSION The high prevalence of fever and low iron-to-zinc molar ratio of the Ultra Rice formulation may have contributed to the lack of improvement in Hb. Alternatively, the detected anemia may not have been due to nutrient deficiencies. Anemia interventions in Burundi should implement multiple strategies to eliminate both iron deficiency and infectious causes of anemia.
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Affiliation(s)
| | - Emily Mosites
- The University of Washington School of Public Health, Seattle, WA, USA
| | | | | | - Melody Waring
- Institute for Research on Poverty University of Wisconsin-Madison, Madison, WI, USA
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Mu M, An P, Wu Q, Shen X, Shao D, Wang H, Zhang Y, Zhang S, Yao H, Min J, Wang F. The dietary flavonoid myricetin regulates iron homeostasis by suppressing hepcidin expression. J Nutr Biochem 2015; 30:53-61. [PMID: 27012621 DOI: 10.1016/j.jnutbio.2015.10.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 10/05/2015] [Accepted: 10/16/2015] [Indexed: 01/09/2023]
Abstract
Hepcidin, a master regulator of iron homeostasis, is a promising target in treatment of iron disorders such as hemochromatosis, anemia of inflammation and iron-deficiency anemia. We previously reported that black soybean seed coat extract could inhibit hepcidin expression. Based on this finding, we performed a screen in cultured cells in order to identify the compounds in black soybeans that inhibit hepcidin expression. We found that the dietary flavonoid myricetin significantly inhibited the expression of hepcidin both in vitro and in vivo. Treating cultured cells with myricetin decreased both HAMP mRNA levels and promoter activity by reducing SMAD1/5/8 phosphorylation. This effect was observed even in the presence of bone morphogenic protein-6 (BMP6) and interleukin-6 (IL-6), two factors that stimulate hepcidin expression. Furthermore, mice that were treated with myricetin (either orally or systemically) had reduced hepatic hepcidin expression, decreased splenic iron levels and increased serum iron levels. Notably, myricetin-treated mice increased red blood cell counts and hemoglobin levels. In addition, pretreating mice with myricetin prevented LPS-induced hypoferremia. We conclude that myricetin potently inhibits hepcidin expression both in vitro and in vivo, and this effect is mediated by altering BMP/SMAD signaling. These experiments highlight the feasibility of identifying and characterizing bioactive phytochemicals to suppress hepcidin expression. These results also suggest that myricetin may represent a novel therapy for treating iron deficiency-related diseases.
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Affiliation(s)
- Mingdao Mu
- Department of Nutrition, Nutrition Discovery Innovation Institute, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; Department of Nutrition, Nutrition Discovery Innovation Center, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Peng An
- Department of Nutrition, Nutrition Discovery Innovation Center, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang 310058, China; The first affiliated Hospital, Institute for Translational Medicine, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Qian Wu
- Department of Nutrition, Nutrition Discovery Innovation Center, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Xiaoyun Shen
- Department of Nutrition, Nutrition Discovery Innovation Center, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Dandan Shao
- Department of Nutrition, Nutrition Discovery Innovation Center, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Hao Wang
- Department of Nutrition, Nutrition Discovery Innovation Center, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Yingqi Zhang
- Department of Nutrition, Nutrition Discovery Innovation Center, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Shenshen Zhang
- Department of Nutrition, Nutrition Discovery Innovation Institute, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Hui Yao
- Traditional Chinese Medicine Department, Zhejiang Hospital, Hangzhou 310013, China
| | - Junxia Min
- The first affiliated Hospital, Institute for Translational Medicine, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Fudi Wang
- Department of Nutrition, Nutrition Discovery Innovation Institute, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; Department of Nutrition, Nutrition Discovery Innovation Center, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang 310058, China.
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Fandrey J, Hallek M. [Erythropoiesis: Physiology, pathophysiology, and algorithm for classification of the type of anemia]. Internist (Berl) 2015; 56:970-7. [PMID: 26338062 DOI: 10.1007/s00108-015-3712-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Erythropoiesis is a continuous process that replaces 1% of all erythrocytes per day. To keep the erythrocyte count within stable limits about 3 million cells/s must be renewed. This enormous turnover requires folic acid and vitamin B12 for proper cell differentiation and iron for sufficient haemoglobin synthesis. In particular, iron metabolism underlies a precise regulation which may be disturbed by chronic bleeding, inflammatory disease or impaired dietary intake. If the loss of red blood cells due to physiological aging or bleeding is not balanced by sufficient erythropoiesis in the bone marrow, anaemia will develop. For the classification of various types of anaemia, a well-established algorithm has been proven useful. This algorithm addresses basic questions such as erythrocyte volume, the underlying mechanism, e.g. whether too many cells are destroyed or new cells are not sufficiently generated, and finally aims to define the main causes for the above identified disturbance of erythropoiesis.
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Affiliation(s)
- J Fandrey
- Institut für Physiologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland,
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Miseta A, Nagy J, Nagy T, Poór VS, Fekete Z, Sipos K. Hepcidin and its potential clinical utility. Cell Biol Int 2015; 39:1191-202. [PMID: 26109250 DOI: 10.1002/cbin.10505] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 06/12/2015] [Indexed: 02/06/2023]
Abstract
A number of pathophysiological conditions are related to iron metabolism disturbances. Some of them are well known, others are newly discovered or special. Hepcidin is a newly identified iron metabolism regulating hormone, which could be a promising biomarker for many disorders. In this review, we provide background information about mammalian iron metabolism, cellular iron trafficking, and the regulation of expression of hepcidin. Beside these molecular biological processes, we summarize the methods that have been used to determine blood and urine hepcidin levels and present those pathological conditions (cancer, inflammation, neurological disorders) when hepcidin measurement may have clinical relevance.
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Affiliation(s)
- Attila Miseta
- Department of Laboratory Medicine, Faculty of Medical Sciences, University of Pécs, 7624 Ifjusag Street 13. Pecs, Hungary
| | - Judit Nagy
- Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences, University of Pécs, 7624 Ifjusag Street 13. Pecs, Hungary
| | - Tamas Nagy
- Department of Laboratory Medicine, Faculty of Medical Sciences, University of Pécs, 7624 Ifjusag Street 13. Pecs, Hungary
| | - Viktor Soma Poór
- Department of Forensic Medicine, Faculty of Medical Sciences, University of Pécs, 7624 Szigeti Street 12. Pecs, Hungary
| | - Zsuzsanna Fekete
- Department of Medical Biology, Faculty of Medical Sciences, University of Pécs, 7624 Szigeti Street 12. Pecs, Hungary
| | - Katalin Sipos
- Department of Pharmaceutical Biology, Faculty of Medical Sciences, University of Pécs, 7624 Rokus Street 2. Pecs, Hungary
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Iron Homeostasis and Trypanosoma brucei Associated Immunopathogenicity Development: A Battle/Quest for Iron. BIOMED RESEARCH INTERNATIONAL 2015; 2015:819389. [PMID: 26090446 PMCID: PMC4450282 DOI: 10.1155/2015/819389] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 02/11/2015] [Accepted: 02/15/2015] [Indexed: 12/24/2022]
Abstract
African trypanosomosis is a chronic debilitating disease affecting the health and economic well-being of developing countries. The immune response during African trypanosome infection consisting of a strong proinflammatory M1-type activation of the myeloid phagocyte system (MYPS) results in iron deprivation for these extracellular parasites. Yet, the persistence of M1-type MYPS activation causes the development of anemia (anemia of chronic disease, ACD) as a most prominent pathological parameter in the mammalian host, due to enhanced erythrophagocytosis and retention of iron within the MYPS thereby depriving iron for erythropoiesis. In this review we give an overview of how parasites acquire iron from the host and how iron modulation of the host MYPS affects trypanosomosis-associated anemia development. Finally, we also discuss different strategies at the level of both the host and the parasite that can/might be used to modulate iron availability during African trypanosome infections.
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Li S, Liu Y, Wang Y, Qi P, Wang D. [The role of serum hepcidin and ferroportin1 in placenta on iron transfer from mother to fetus]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2015; 36:307-11. [PMID: 25916292 PMCID: PMC7342627 DOI: 10.3760/cma.j.issn.0253-2727.2015.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To detect the concentration of serum hepcidin and the mRNA expression level of ferroportin1 (FPN1) in the placenta membrane from full term pregnant women with different degree of iron deficiency, and explore their roles for iron transport in placental. METHODS The concentration of HGB, serum iron (SI) and serum ferritin (SF) of mothers and infants were detected in 55 full term pregnant women and neonates. The expression level of FPN1 mRNA in placental was detected by the RT-PCR technique. The concentration of serum hepcidin was detected by double antibody sandwich biotin avidin enzyme-linked immunosorbent assay. The serum hepcidin level and the FPN1 mRNA expression in the full term placenta from different maternal iron status were compared in three groups. RESULTS There were no significant differences in the cord blood HGB, SI and SF of newborns from pregnant women with different iron status (P>0.05). The concentration of serum hepcidin of pregnant women among normal, iron deficiency and mild iron deficiency anemia were (193.637±52.219), (176.523±43.875), and (147.623±37.768) μg/L respectively, with statistical significance (F=3.872, P=0.027). The expression levels of FPN1 mRNA among three groups were 0.462±0.077, 0.507±0.074 and 0.551±0.104 respectively, with statistical significance (F=4.767, P=0.013). A negative correlation between maternal serum hepcidin and placental FPN1 mRNA (r=-0.383, P=0.004) was identified. CONCLUSION There were no significant differences in the iron status of corresponding newborns from pregnant women with different iron status. With the severity of maternal iron deficiency, the concentration of serum hepcidin was down-regulated, while the expression of FPN1 mRNA in placenta was up-regulated.
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Affiliation(s)
- Sibao Li
- Department of Pediartics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yufeng Liu
- Department of Pediartics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yumei Wang
- Department of Pediartics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Peihong Qi
- Department of Pediartics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Diao Wang
- Department of Pediartics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Vagace JM, Peças A, Groiss J, Bento C, Ribeiro ML, Gervasini G. Clinical relevance of erythrocyte ferritin in microcytic anemias. Clin Chim Acta 2015; 442:1-5. [PMID: 25562818 DOI: 10.1016/j.cca.2014.12.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 11/17/2014] [Accepted: 12/10/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Erythrocyte ferritin (EF) reflects the balance between iron supply and its utilization for hemoglobin synthesis. This balance is altered in microcytosis. We aimed to evaluate the diagnostic value of both EF and the ratio (FRR) plasma ferritin (PF)/EF in these disorders. METHODS A total of 231 subjects participated in the study. Samples from 93 adult patients with different causes of microcytosis, 57 healthy subjects and 81 full-term newborns were analyzed to determine EF and PF concentrations and other hematological parameters. RESULTS In patients with iron deficiency, and in contrast to PF, EF decreased only in the presence of anemia and in direct correlation with the degree of microcytosis (Pearson's p<0.001). EF values for thalassemia patients were higher than those observed in controls (p<10e-5), while PF concentrations were similar between these groups. This EF increase was more marked in the delta-beta thalassemia group (p<0.05). Finally, FRR was much higher in patients with anemia of inflammation than in those with thalassemia (p<10e-5), thus helping to discriminate between these disorders. CONCLUSIONS EF and FRR are tools that may be useful in the diagnosis of the main causes of microcytosis.
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Affiliation(s)
- Jose M Vagace
- Service of Hematology, Infanta Cristina Hospital, Badajoz, Spain.
| | - Antonio Peças
- Service of Hematology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Jorge Groiss
- Service of Hematology, Infanta Cristina Hospital, Badajoz, Spain
| | - Celeste Bento
- Service of Hematology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Maria Leticia Ribeiro
- Service of Hematology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Guillermo Gervasini
- Department of Surgical and Medical Therapeutics, University of Extremadura, Badajoz, Spain
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Genome-wide association study identifies TF as a significant modifier gene of iron metabolism in HFE hemochromatosis. J Hepatol 2015; 62:664-72. [PMID: 25457201 DOI: 10.1016/j.jhep.2014.10.017] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 09/25/2014] [Accepted: 10/09/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND & AIMS Hereditary hemochromatosis (HH) is the most common form of genetic iron loading disease. It is mainly related to the homozygous C282Y/C282Y mutation in the HFE gene that is, however, a necessary but not a sufficient condition to develop clinical and even biochemical HH. This suggests that modifier genes are likely involved in the expressivity of the disease. Our aim was to identify such modifier genes. METHODS We performed a genome-wide association study (GWAS) using DNA collected from 474 unrelated C282Y homozygotes. Associations were examined for both quantitative iron burden indices and clinical outcomes with 534,213 single nucleotide polymorphisms (SNP) genotypes, with replication analyses in an independent sample of 748 C282Y homozygotes from four different European centres. RESULTS One SNP met genome-wide statistical significance for association with transferrin concentration (rs3811647, GWAS p value of 7×10(-9) and replication p value of 5×10(-13)). This SNP, located within intron 11 of the TF gene, had a pleiotropic effect on serum iron (GWAS p value of 4.9×10(-6) and replication p value of 3.2×10(-6)). Both serum transferrin and iron levels were associated with serum ferritin levels, amount of iron removed and global clinical stage (p<0.01). Serum iron levels were also associated with fibrosis stage (p<0.0001). CONCLUSIONS This GWAS, the largest one performed so far in unselected HFE-associated HH (HFE-HH) patients, identified the rs3811647 polymorphism in the TF gene as the only SNP significantly associated with iron metabolism through serum transferrin and iron levels. Because these two outcomes were clearly associated with the biochemical and clinical expression of the disease, an indirect link between the rs3811647 polymorphism and the phenotypic presentation of HFE-HH is likely.
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Foka P, Dimitriadis A, Kyratzopoulou E, Giannimaras DA, Sarno S, Simos G, Georgopoulou U, Mamalaki A. A complex signaling network involving protein kinase CK2 is required for hepatitis C virus core protein-mediated modulation of the iron-regulatory hepcidin gene expression. Cell Mol Life Sci 2014; 71:4243-58. [PMID: 24718935 PMCID: PMC11114079 DOI: 10.1007/s00018-014-1621-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 02/25/2014] [Accepted: 03/24/2014] [Indexed: 12/18/2022]
Abstract
Hepatitis C virus (HCV) infection is associated with hepatic iron overload and elevated serum iron that correlate to poor antiviral responses. Hepcidin (HAMP), a 25-aa cysteine-rich liver-specific peptide, controls iron homeostasis. Its expression is up-regulated in inflammation and iron excess. HCV-mediated hepcidin regulation remains controversial. Chronic HCV patients possess relatively low hepcidin levels; however, elevated HAMP mRNA has been reported in HCV core transgenic mice and HCV replicon-expressing cells. We investigated the effect of HCV core protein on HAMP gene expression and delineated the complex interplay of molecular mechanisms involved. HCV core protein up-regulated HAMP promoter activity, mRNA, and secreted protein levels. Enhanced promoter activity was abolished by co-transfections of core with HAMP promoter constructs containing mutated/deleted BMP and STAT binding sites. Dominant negative constructs, pharmacological inhibitors, and silencing experiments against STAT3 and SMAD4 confirmed the participation of both pathways in HAMP gene regulation by core protein. STAT3 and SMAD4 expression levels were found increased in the presence of HCV core, which orchestrated SMAD4 translocation into the nucleus and STAT3 phosphorylation. To further understand the mechanisms governing the core effect, the role of the JAK/STAT-activating kinase CK2 was investigated. A CK2-dominant negative construct, a CK2-specific inhibitor, and RNAi interference abrogated the core-induced increase on HAMP promoter activity, mRNA, and protein levels, while CK2 acted in synergy with core to significantly enhance HAMP gene expression. Therefore, HCV core up-regulates HAMP gene transcription via a complex signaling network that requires both SMAD/BMP and STAT3 pathways and CK2 involvement.
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Affiliation(s)
- Pelagia Foka
- Laboratory of Molecular Biology and Immunobiotechnology, Department of Biochemistry, Hellenic Pasteur Institute, Athens, Greece
- Laboratory of Molecular Virology, Hellenic Pasteur Institute, Athens, Greece
| | - Alexios Dimitriadis
- Laboratory of Molecular Biology and Immunobiotechnology, Department of Biochemistry, Hellenic Pasteur Institute, Athens, Greece
| | - Eleni Kyratzopoulou
- Laboratory of Molecular Biology and Immunobiotechnology, Department of Biochemistry, Hellenic Pasteur Institute, Athens, Greece
| | - Dionysios A. Giannimaras
- Laboratory of Molecular Biology and Immunobiotechnology, Department of Biochemistry, Hellenic Pasteur Institute, Athens, Greece
| | - Stefania Sarno
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - George Simos
- Laboratory of Biochemistry, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Urania Georgopoulou
- Laboratory of Molecular Virology, Hellenic Pasteur Institute, Athens, Greece
| | - Avgi Mamalaki
- Laboratory of Molecular Biology and Immunobiotechnology, Department of Biochemistry, Hellenic Pasteur Institute, Athens, Greece
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Kanamori Y, Murakami M, Matsui T, Funaba M. The regulation of hepcidin expression by serum treatment: requirements of the BMP response element and STAT- and AP-1-binding sites. Gene 2014; 551:119-26. [PMID: 25151311 DOI: 10.1016/j.gene.2014.08.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 06/26/2014] [Accepted: 08/20/2014] [Indexed: 12/26/2022]
Abstract
Expression of hepcidin, a central regulator of systemic iron metabolism, is transcriptionally regulated by the bone morphogenetic protein (BMP) pathway. However, the factors other than the BMP pathway also participate in the regulation of hepcidin expression. In the present study, we show that serum treatment increased hepcidin expression and transcription without inducing the phosphorylation of Smad1/5/8 in primary hepatocytes, HepG2 cells or Hepa1-6 cells. Co-treatment with LDN-193189, an inhibitor of the BMP type I receptor, abrogated this hepcidin induction. Reporter assays using mutated reporters revealed the involvement of the BMP response element-1 (BMP-RE1) and signal transducers and activator of transcription (STAT)- and activator protein (AP)-1-binding sites in serum-induced hepcidin transcription in HepG2 cells. Serum treatment induced the expression of the AP-1 components c-fos and junB in primary hepatocytes and HepG2 cells. Forced expression of c-fos or junB enhanced the response of hepcidin transcription to serum treatment. By contrast, the expression of dominant negative (dn)-c-fos and dn-junB decreased hepcidin transcription. The present study reveals that serum contains factors stimulating hepcidin transcription. Basal BMP activity is essential for the serum-induced hepcidin transcription, although serum treatment does not stimulate the BMP pathway. The induction of c-fos and junB by serum treatment stimulates hepcidin transcription, through possibly cooperation with BMP-mediated signaling. Considering that AP-1 is induced by various stimuli, the present results suggest that hepcidin expression is regulated by more diverse factors than had been previously considered.
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Affiliation(s)
- Yohei Kanamori
- Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, Kyoto 606-8502, Japan
| | - Masaru Murakami
- Laboratory of Molecular Biology, Azabu University School of Veterinary Medicine, Sagamihara 252-5201, Japan
| | - Tohru Matsui
- Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, Kyoto 606-8502, Japan
| | - Masayuki Funaba
- Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, Kyoto 606-8502, Japan.
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Kallianpur AR, Jia P, Ellis RJ, Zhao Z, Bloss C, Wen W, Marra CM, Hulgan T, Simpson DM, Morgello S, McArthur JC, Clifford DB, Collier AC, Gelman BB, McCutchan JA, Franklin D, Samuels DC, Rosario D, Holzinger E, Murdock DG, Letendre S, Grant I. Genetic variation in iron metabolism is associated with neuropathic pain and pain severity in HIV-infected patients on antiretroviral therapy. PLoS One 2014; 9:e103123. [PMID: 25144566 PMCID: PMC4140681 DOI: 10.1371/journal.pone.0103123] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 06/27/2014] [Indexed: 02/06/2023] Open
Abstract
HIV sensory neuropathy and distal neuropathic pain (DNP) are common, disabling complications associated with combination antiretroviral therapy (cART). We previously associated iron-regulatory genetic polymorphisms with a reduced risk of HIV sensory neuropathy during more neurotoxic types of cART. We here evaluated the impact of polymorphisms in 19 iron-regulatory genes on DNP in 560 HIV-infected subjects from a prospective, observational study, who underwent neurological examinations to ascertain peripheral neuropathy and structured interviews to ascertain DNP. Genotype-DNP associations were explored by logistic regression and permutation-based analytical methods. Among 559 evaluable subjects, 331 (59%) developed HIV-SN, and 168 (30%) reported DNP. Fifteen polymorphisms in 8 genes (p<0.05) and 5 variants in 4 genes (p<0.01) were nominally associated with DNP: polymorphisms in TF, TFRC, BMP6, ACO1, SLC11A2, and FXN conferred reduced risk (adjusted odds ratios [ORs] ranging from 0.2 to 0.7, all p<0.05); other variants in TF, CP, ACO1, BMP6, and B2M conferred increased risk (ORs ranging from 1.3 to 3.1, all p<0.05). Risks associated with some variants were statistically significant either in black or white subgroups but were consistent in direction. ACO1 rs2026739 remained significantly associated with DNP in whites (permutation p<0.0001) after correction for multiple tests. Several of the same iron-regulatory-gene polymorphisms, including ACO1 rs2026739, were also associated with severity of DNP (all p<0.05). Common polymorphisms in iron-management genes are associated with DNP and with DNP severity in HIV-infected persons receiving cART. Consistent risk estimates across population subgroups and persistence of the ACO1 rs2026739 association after adjustment for multiple testing suggest that genetic variation in iron-regulation and transport modulates susceptibility to DNP.
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Affiliation(s)
- Asha R. Kallianpur
- Department of Genomic Medicine, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Peilin Jia
- Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Ronald J. Ellis
- Department of Neurology, University of California San Diego, San Diego, California, United States of America
| | - Zhongming Zhao
- Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Cinnamon Bloss
- Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health, La Jolla, California, United States of America
| | - Wanqing Wen
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Christina M. Marra
- Department of Neurology, University of Washington, Seattle, Washington, United States of America
| | - Todd Hulgan
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - David M. Simpson
- Department of Neurology, Icahn School of Medicine of Mt. Sinai, New York, New York, United States of America
| | - Susan Morgello
- Department of Neurology, Icahn School of Medicine of Mt. Sinai, New York, New York, United States of America
| | - Justin C. McArthur
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - David B. Clifford
- Department of Neurology, Washington University, St. Louis, Missouri, United States of America
| | - Ann C. Collier
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Benjamin B. Gelman
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - J. Allen McCutchan
- Department of Medicine, University of California San Diego, San Diego, California, United States of America
| | - Donald Franklin
- HIV Neurobehavioral Research Center & CHARTER Center, University of California San Diego, San Diego, California, United States of America
| | - David C. Samuels
- Department of Molecular Physiology and Biophysics and Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Debralee Rosario
- HIV Neurobehavioral Research Center & CHARTER Center, University of California San Diego, San Diego, California, United States of America
| | - Emily Holzinger
- Department of Molecular Physiology and Biophysics and Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Deborah G. Murdock
- Department of Molecular Physiology and Biophysics and Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Scott Letendre
- Department of Medicine, University of California San Diego, San Diego, California, United States of America
| | - Igor Grant
- Department of Psychiatry, University of California San Diego, San Diego, California, United States of America
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Abstract
SIGNIFICANCE Iron is the most abundant transition metal in biology and an essential cofactor for many cellular enzymes. Iron homeostasis impairment is also a component of peripheral neuropathies. RECENT ADVANCES During the past years, much effort has been paid to understand the molecular mechanism involved in maintaining systemic iron homeostasis in mammals. This has been stimulated by the evidence that iron dyshomeostasis is an initial cause of several disorders, including genetic and sporadic neurodegenerative disorders. CRITICAL ISSUES However, very little has been done to investigate the physiological role of iron in peripheral nervous system (PNS), despite the development of suitable cellular and animal models. FUTURE DIRECTIONS To stimulate research on iron metabolism and peripheral neuropathy, we provide a summary of the knowledge on iron homeostasis in the PNS, on its transport across the blood-nerve barrier, its involvement in myelination, and we identify unresolved questions. Furthermore, we comment on the role of iron in iron-related disorder with peripheral component, in demyelinating and metabolic peripheral neuropathies.
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Affiliation(s)
- Sonia Levi
- 1 University Vita-Salute San Raffaele , Milan, Italy
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Wright JA, Richards T, Srai SKS. The role of iron in the skin and cutaneous wound healing. Front Pharmacol 2014; 5:156. [PMID: 25071575 PMCID: PMC4091310 DOI: 10.3389/fphar.2014.00156] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 06/16/2014] [Indexed: 11/13/2022] Open
Abstract
In this review article we discuss current knowledge about iron in the skin and the cutaneous wound healing process. Iron plays a key role in both oxidative stress and photo-induced skin damage. The main causes of oxidative stress in the skin include reactive oxygen species (ROS) generated in the skin by ultraviolet (UVA) 320-400 nm portion of the UVA spectrum and biologically available iron. We also discuss the relationships between iron deficiency, anemia and cutaneous wound healing. Studies looking at this fall into two distinct groups. Early studies investigated the effect of anemia on wound healing using a variety of experimental methodology to establish anemia or iron deficiency and focused on wound-strength rather than effect on macroscopic healing or re-epithelialization. More recent animal studies have investigated novel treatments aimed at correcting the effects of systemic iron deficiency and localized iron overload. Iron overload is associated with local cutaneous iron deposition, which has numerous deleterious effects in chronic venous disease and hereditary hemochromatosis. Iron plays a key role in chronic ulceration and conditions such as rheumatoid arthritis (RA) and Lupus Erythematosus are associated with both anemia of chronic disease and dysregulation of local cutaneous iron hemostasis. Iron is a potential therapeutic target in the skin by application of topical iron chelators and novel pharmacological agents, and in delayed cutaneous wound healing by treatment of iron deficiency or underlying systemic inflammation.
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Affiliation(s)
- Josephine A Wright
- Division of Surgery and Interventional Science, University College London, University College & Royal Free Hospitals London, UK
| | - Toby Richards
- Division of Surgery and Interventional Science, University College London, University College & Royal Free Hospitals London, UK
| | - Surjit K S Srai
- Department of Structural and Molecular Biology, Division of Biosciences, University College London London, UK
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Shanmugam NKN, Trebicka E, Fu LL, Shi HN, Cherayil BJ. Intestinal inflammation modulates expression of the iron-regulating hormone hepcidin depending on erythropoietic activity and the commensal microbiota. THE JOURNAL OF IMMUNOLOGY 2014; 193:1398-407. [PMID: 24973448 DOI: 10.4049/jimmunol.1400278] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
States of chronic inflammation such as inflammatory bowel disease are often associated with dysregulated iron metabolism and the consequent development of an anemia that is caused by maldistribution of iron. Abnormally elevated expression of the hormone hepcidin, the central regulator of systemic iron homeostasis, has been implicated in these abnormalities. However, the mechanisms that regulate hepcidin expression in conditions such as inflammatory bowel disease are not completely understood. To clarify this issue, we studied hepcidin expression in mouse models of colitis. We found that dextran sulfate sodium-induced colitis inhibited hepcidin expression in wild-type mice but upregulated it in IL-10-deficient animals. We identified two mechanisms contributing to this difference. Firstly, erythropoietic activity, as indicated by serum erythropoietin concentrations and splenic erythropoiesis, was higher in the wild-type mice, and pharmacologic inhibition of erythropoiesis prevented colitis-associated hepcidin downregulation in these animals. Secondly, the IL-10 knockout mice had higher expression of multiple inflammatory genes in the liver, including several controlled by STAT3, a key regulator of hepcidin. The results of cohousing and fecal transplantation experiments indicated that the microbiota was involved in modulating the expression of hepcidin and other STAT3-dependent hepatic genes in the context of intestinal inflammation. Our observations thus demonstrate the importance of erythropoietic activity and the microbiota in influencing hepcidin expression during colitis and provide insight into the dysregulated iron homeostasis seen in inflammatory diseases.
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Affiliation(s)
- Nanda Kumar N Shanmugam
- Department of Pediatrics, Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129; and
| | - Estela Trebicka
- Department of Pediatrics, Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129; and
| | - Ling-Lin Fu
- Department of Pediatrics, Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129; and Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou 310035, People's Republic of China
| | - Hai Ning Shi
- Department of Pediatrics, Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129; and
| | - Bobby J Cherayil
- Department of Pediatrics, Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129; and
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Ma B, Kang Q, Qin L, Cui L, Pei C. TGF-β2 induces transdifferentiation and fibrosis in human lens epithelial cells via regulating gremlin and CTGF. Biochem Biophys Res Commun 2014; 447:689-95. [DOI: 10.1016/j.bbrc.2014.04.068] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 04/14/2014] [Indexed: 01/20/2023]
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Gotardo &EMF, Ribeiro GDA, Clemente TRL, Moscato CH, Tomé RBG, Rocha T, Pedrazzoli Jr J, Ribeiro ML, Gambero A. Hepcidin expression in colon during trinitrobenzene sulfonic acid-induced colitis in rats. World J Gastroenterol 2014; 20:4345-4352. [PMID: 24764672 PMCID: PMC3989970 DOI: 10.3748/wjg.v20.i15.4345] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 12/18/2013] [Accepted: 01/20/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate hepcidin expression, interleukin-6 (IL-6) production and iron levels in the rat colon in the presence of trinitrobenzene sulfonic acid (TNBS)-induced colitis.
METHODS: In rats, we evaluated the severity of colitis induced by repeated TNBS administration using macroscopic and microscopic scoring systems and myeloperoxidase activity measurements. The colonic levels of hepcidin, tumor necrosis factor alpha (TNF-α), IL-10 and IL-6 were measured by Enzyme-Linked Immunosorbent Assay, and hepcidin-25 expression and iron deposition were analyzed by immunohistochemistry and the Prussian blue reaction, respectively. Stat-3 phosphorylation was assessed by Western blot analysis. Hematological parameters, iron and transferrin levels, and transferrin saturation were also measured. Additionally, the ability of iron, pathogen-derived molecules and IL-6 to induce hepcidin expression in HT-29 cells was evaluated.
RESULTS: Repeated TNBS administration to rats resulted in macroscopically and microscopically detectable colon lesions and elevated colonic myeloperoxidase activity. Hepcidin-25 protein levels were increased in colonic surface epithelia in colitic rats (10.2 ± 4.0 pg/mg protein vs 71.0 ± 8.4 pg/mg protein, P < 0.01). Elevated IL-6 levels (8.2 ± 1.7 pg/mg protein vs 14.7 ± 0.7 pg/mg protein, P < 0.05), TNF-α levels (1.8 ± 1.2 pg/mg protein vs 7.4 ± 2.1 pg/mg protein, P < 0.05) and Stat-3 phosphorylation were also observed. Systemic alterations in iron homeostasis, hepcidin levels and anemia were not detected in colitic rats. Iron deposition in the colon was only observed during colitis. Hepcidin gene expression was increased in HT-29 cells after IL-6 and lipopolysaccharide [a toll-like receptor 4 (TLR-4) ligand] treatment. Deferoxamine, ferric citrate and peptidoglycan (a TLR-2 ligand) were unable to alter the in vitro expression of hepcidin in HT-29 cells.
CONCLUSION: Colitis increased local hepcidin-25 expression, which was associated with the IL-6/Stat-3 signaling pathway. An increase in local iron sequestration was also observed, but additional studies are needed to determine whether this sequestration is a defensive or pathological response to intestinal inflammation.
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Jelkmann W. The ESA scenario gets complex: from biosimilar epoetins to activin traps. Nephrol Dial Transplant 2014; 30:553-9. [PMID: 24748667 DOI: 10.1093/ndt/gfu089] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Recombinant human erythropoietin (rhEpo, epoetin) has proved beneficial in preventing transfusion-dependent anaemia in patients with chronic kidney disease. Apart from copied epoetins distributed in less regulated markets, 'biosimilar' epoetins have gained currency in many regions, where they compete with the originals and with rhEpo analogues with prolonged survival in circulation ('biobetter'). Recombinant erythropoiesis stimulating agents are potent and well tolerated. However, their production is costly, and they must be administered by the parenteral route. Hence, other anti-anaemia treatments are being evaluated. Clinical trials are being performed with stabilizers of the hypoxia-inducible transcription factors (HIFs), which increase endogenous Epo production. HIF stabilizers are chemical drugs and they are active on oral administration. However, there is fear that they may promote tumour growth. Epo mimetic peptides have also raised expectations. Yet the prototype peginesatide was recalled after just 1 year of its widespread use in the USA because of serious side-effects including cases of death. Most recently, clinical trials have been initiated with sotatercept, a recombinant soluble activin receptor type 2A IgG-Fc fusion protein. Sotatercept binds distinct members of the transforming growth factor-β family, thereby preventing the inhibitory action of these factors in erythropoiesis. Taken together, rhEpo and its long-acting recombinant analogues will likely remain mainstay of anti-anaemia therapies in the near future.
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Potential roles of bone morphogenetic protein (BMP)-9 in human liver diseases. Int J Mol Sci 2014; 15:5199-220. [PMID: 24670474 PMCID: PMC4013558 DOI: 10.3390/ijms15045199] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 03/07/2014] [Accepted: 03/17/2014] [Indexed: 01/01/2023] Open
Abstract
Bone morphogenetic proteins (BMP-2 to BMP-15) belong to the Transforming Growth Factor (TGF)-β superfamily and, besides their well-documented roles during embryogenesis and bone formation, some of them have recently been described to be involved in the pathogenesis of different organs, including the liver. The role of BMPs in liver damage responses including hepatocellular carcinoma (HCC) development has only begun to be addressed and strong evidence supports the concept of a pro-tumorigenic role of BMP signaling in HCC cells. BMP-9 (also termed Growth and Differentiation Factor (GDF)-2) represents the most recently discovered member of the BMP family. We have previously demonstrated that in HCC patient samples BMP-9 expression was positively associated with the tumor seize (“T stage”) and that it enhanced cell migration and induced epithelial to mesenchymal transition (EMT) in HCC cells in vitro. In another study we recently found that BMP-9 promotes growth in HCC cells, but not in non-transformed hepatocytes. Published as well as unpublished results obtained with primary hepatocytes support the concept of a dual function of BMP-9 in the liver: while in primary, non-malignant cells BMP-9 stabilizes the epithelial phenotype and inhibits proliferation, in HCC cells it induces cell growth and the acquisition of a migratory phenotype. In this review article we summarize current knowledge about BMPs in liver diseases, with special focus on the role of BMP-9 in HCC development and progression, that may provide new clues for a better understanding of the contribution of BMP-signaling to chronic liver diseases.
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Shah YM, Xie L. Hypoxia-inducible factors link iron homeostasis and erythropoiesis. Gastroenterology 2014; 146:630-42. [PMID: 24389303 PMCID: PMC3943938 DOI: 10.1053/j.gastro.2013.12.031] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 12/06/2013] [Accepted: 12/10/2013] [Indexed: 12/15/2022]
Abstract
Iron is required for efficient oxygen transport, and hypoxia signaling links erythropoiesis with iron homeostasis. Hypoxia induces a highly conserved signaling pathway in cells under conditions of low levels of O2. One component of this pathway, hypoxia-inducible factor (HIF), is a transcription factor that is highly active in hypoxic cells. The first HIF target gene characterized was EPO, which encodes erythropoietin-a glycoprotein hormone that controls erythropoiesis. In the past decade, there have been fundamental advances in our understanding of how hypoxia regulates iron levels to support erythropoiesis and maintain systemic iron homeostasis. We review the cell type-specific effects of hypoxia and HIFs in adaptive response to changes in oxygen and iron availability as well as potential uses of HIF modulators for patients with iron-related disorders.
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Affiliation(s)
- Yatrik M. Shah
- Department of Molecular & Integrative Physiology, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan,Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, To whom correspondence should be addressed. Tel: +1 734 6150567; Fax: +1 734 9368813;
| | - Liwei Xie
- Department of Molecular & Integrative Physiology, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan
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Budak H, Gonul N, Ceylan H, Kocpinar EF. Impact of long term Fe³⁺ toxicity on expression of glutathione system in rat liver. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2014; 37:365-370. [PMID: 24388910 DOI: 10.1016/j.etap.2013.12.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 12/09/2013] [Accepted: 12/13/2013] [Indexed: 06/03/2023]
Abstract
The free radicals within the body, produced by metabolic activities or derived from environmental sources are relatively related to hepatoxicity. Since heavy metals including iron have the ability to produce free radicals, the liver glutathione system neutralizes them to protect cells against any damage. The objective of this study is to indicate the toxic effects of iron on the glutathione system at the enzymatic and molecular level. Thus, any possible correlation between enzymatic and molecular levels can be determined. According to our results, while mRNA expression of glutathione reductase (Gsr) and glutathione S-transferases (Gsta5) genes were not affected by long-term exposure to various concentrations of iron (Fe(3+)), transcription level of glutathione peroxidase (Gpx2) was influenced in the presence of toxic iron. Whereas the enzyme activites of GSR (GR), GPX and GST were significantly affected in rat liver.
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Affiliation(s)
- Harun Budak
- Ataturk University, Science Faculty, Department of Molecular Biology and Genetics, 25240 Erzurum, Turkey.
| | - Nurdan Gonul
- Ataturk University, Science Faculty, Department of Molecular Biology and Genetics, 25240 Erzurum, Turkey
| | - Hamid Ceylan
- Ataturk University, Science Faculty, Department of Molecular Biology and Genetics, 25240 Erzurum, Turkey
| | - Enver Fehim Kocpinar
- Ataturk University, Science Faculty, Department of Chemistry, 25240 Erzurum, Turkey
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Caza M, Kronstad JW. Shared and distinct mechanisms of iron acquisition by bacterial and fungal pathogens of humans. Front Cell Infect Microbiol 2013; 3:80. [PMID: 24312900 PMCID: PMC3832793 DOI: 10.3389/fcimb.2013.00080] [Citation(s) in RCA: 159] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Accepted: 10/30/2013] [Indexed: 12/12/2022] Open
Abstract
Iron is the most abundant transition metal in the human body and its bioavailability is stringently controlled. In particular, iron is tightly bound to host proteins such as transferrin to maintain homeostasis, to limit potential damage caused by iron toxicity under physiological conditions and to restrict access by pathogens. Therefore, iron acquisition during infection of a human host is a challenge that must be surmounted by every successful pathogenic microorganism. Iron is essential for bacterial and fungal physiological processes such as DNA replication, transcription, metabolism, and energy generation via respiration. Hence, pathogenic bacteria and fungi have developed sophisticated strategies to gain access to iron from host sources. Indeed, siderophore production and transport, iron acquisition from heme and host iron-containing proteins such as hemoglobin and transferrin, and reduction of ferric to ferrous iron with subsequent transport are all strategies found in bacterial and fungal pathogens of humans. This review focuses on a comparison of these strategies between bacterial and fungal pathogens in the context of virulence and the iron limitation that occurs in the human body as a mechanism of innate nutritional defense.
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Affiliation(s)
| | - James W. Kronstad
- The Michael Smith Laboratories, Department of Microbiology and Immunology, University of British ColumbiaVancouver, BC, Canada
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Zumbrennen-Bullough K, Babitt JL. The iron cycle in chronic kidney disease (CKD): from genetics and experimental models to CKD patients. Nephrol Dial Transplant 2013; 29:263-73. [PMID: 24235084 DOI: 10.1093/ndt/gft443] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Iron is essential for most living organisms but iron excess can be toxic. Cellular and systemic iron balance is therefore tightly controlled. Iron homeostasis is dysregulated in chronic kidney disease (CKD) and contributes to the anemia that is prevalent in this patient population. Iron supplementation is one cornerstone of anemia management in CKD patients, but has not been rigorously studied in large prospective randomized controlled trials. This review highlights important advances from genetic studies and animal models that have provided key insights into the molecular mechanisms governing iron homeostasis and its disturbance in CKD, and summarizes how these findings may yield advances in the care of this patient population.
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Affiliation(s)
- Kimberly Zumbrennen-Bullough
- Program in Anemia Signaling Research, Division of Nephrology, Program in Membrane Biology, Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Fujiwara T, Ikeda T, Nagasaka Y, Okitsu Y, Katsuoka Y, Fukuhara N, Onishi Y, Ishizawa K, Ichinohasama R, Tomosugi N, Harigae H. A low-molecular-weight compound K7174 represses hepcidin: possible therapeutic strategy against anemia of chronic disease. PLoS One 2013; 8:e75568. [PMID: 24086573 PMCID: PMC3785497 DOI: 10.1371/journal.pone.0075568] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 08/14/2013] [Indexed: 12/21/2022] Open
Abstract
Hepcidin is the principal iron regulatory hormone, controlling the systemic absorption and remobilization of iron from intracellular stores. The expression of the hepcidin gene, HAMP, is increased in patients with anemia of chronic disease. Previously, the synthetic compound K7174 was identified through chemical screening as a novel inhibitor of the adhesion of monocytes to cytokine-stimulated endothelial cells. K7174 also ameliorated anemia induced by inflammatory cytokines in mice, which suggests a possible involvement of hepcidin regulation. The present study was performed to assess the impact of K7174 on hepcidin expression in a human hematoma cell line and in mice in vivo. We first demonstrated that K7174 treatment in HepG2 cells significantly decreased HAMP expression. Then, we conducted microarray analysis to determine the molecular mechanism by which K7174 inhibits HAMP expression. Transcriptional profiling confirmed the downregulation of HAMP. Surprisingly, we found that K7174 strongly induced GDF15, known as a negative regulator of HAMP expression. Western blotting analysis as well as ELISA confirmed the induction of GDF15 by K7174 treatment. Furthermore, K7174-mediated HAMP suppression was rescued by the silencing of GDF15 expression. Interestingly, we found that K7174 also upregulates CEBPB. Promoter analysis and chromatin immunoprecipitation analysis revealed that CEBPB could contribute to K7174-mediated transcriptional activation of GDF15. Subsequently, we also examined whether K7174 inhibits hepcidin expression in mice. Quantitative RT-PCR analysis with liver samples from K7174-treated mice demonstrated significant upregulation of Gdf15 and downregulation of Hamp expression, as compared to control mice. Furthermore, serum hepcidin concentration was also significantly decreased in K7174-treated mice. In conclusion, K7174 inhibits hepcidin expression partly by inducing GDF15. K-7174 may be a potential therapeutic option to treat anemia of chronic disease.
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Affiliation(s)
- Tohru Fujiwara
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan
- Molecular Hematology/Oncology, Tohoku University Graduate School, Sendai, Japan
| | - Takashi Ikeda
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan
| | - Yuki Nagasaka
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan
| | - Yoko Okitsu
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan
| | - Yuna Katsuoka
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan
| | - Noriko Fukuhara
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan
| | - Yasushi Onishi
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan
| | - Kenichi Ishizawa
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan
- Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Japan
| | - Ryo Ichinohasama
- Hematopathology, Tohoku University Graduate School, Sendai, Japan
| | - Naohisa Tomosugi
- Aging Research Unit, Division of Advanced Medicine, Medical Research Institute, Kanazawa Medical College, Kanazawa, Japan
| | - Hideo Harigae
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan
- Molecular Hematology/Oncology, Tohoku University Graduate School, Sendai, Japan
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Stefashyna O, Stern M, Infanti L, Holbro A, Tichelli A, Buser A, O'Meara A. Pattern of care of blood donors with early-uncomplicated hereditary haemochromatosis in a Swiss blood donation centre. Vox Sang 2013; 106:111-7. [DOI: 10.1111/vox.12078] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 07/27/2013] [Accepted: 08/05/2013] [Indexed: 12/27/2022]
Affiliation(s)
- O. Stefashyna
- Blood Transfusion Centre; Swiss Red Cross; Basel Switzerland
| | - M. Stern
- Hematology; University Hospital; Basel Switzerland
| | - L. Infanti
- Blood Transfusion Centre; Swiss Red Cross; Basel Switzerland
| | - A. Holbro
- Blood Transfusion Centre; Swiss Red Cross; Basel Switzerland
| | - A. Tichelli
- Hematology; University Hospital; Basel Switzerland
| | - A. Buser
- Blood Transfusion Centre; Swiss Red Cross; Basel Switzerland
| | - A. O'Meara
- Hematology; University Hospital; Basel Switzerland
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Jelkmann I, Jelkmann W. Impact of erythropoietin on intensive care unit patients. ACTA ACUST UNITED AC 2013; 40:310-8. [PMID: 24273484 DOI: 10.1159/000354128] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 08/06/2013] [Indexed: 12/13/2022]
Abstract
Anemia is common in intensive care unit (ICU) patients. Red blood cell (RBC) transfusions are mainstays of their treatment and can be life-saving. Allogeneic blood components inherently bear risks of infection and immune reactions. Although these risks are rare in developed countries, recombinant human erythropoietin (rhEpo) and other erythropoiesis-stimulating agents (ESAs) have been considered alternative anti-anemia treatment options. As summarized herein, however, most of the clinical studies suggest that ESAs are not usually advisable in ICU patients unless approved indications exist (e.g., renal disease). First, ESAs act in a delayed way, inducing an increase in reticulocytes only after a lag of 3-4 days. Second, many critically ill patients present with ESA resistance as inflammatory mediators impair erythropoietic cell proliferation and iron availability. Third, the ESA doses used for treatment of ICU patients are very high. Fourth, ESAs are not legally approved for general use in ICU patients. Solely in distinct cases, such as Jehovah's Witnesses who refuse allogeneic blood transfusions due to religious beliefs, ESAs may be considered an exceptional therapy.
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Affiliation(s)
- Ines Jelkmann
- Department of Surgery, University of Lübeck, Germany
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Out of balance--systemic iron homeostasis in iron-related disorders. Nutrients 2013; 5:3034-61. [PMID: 23917168 PMCID: PMC3775241 DOI: 10.3390/nu5083034] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 07/16/2013] [Accepted: 07/19/2013] [Indexed: 02/06/2023] Open
Abstract
Iron is an essential element in our daily diet. Most iron is required for the de novo synthesis of red blood cells, where it plays a critical role in oxygen binding to hemoglobin. Thus, iron deficiency causes anemia, a major public health burden worldwide. On the other extreme, iron accumulation in critical organs such as liver, heart, and pancreas causes organ dysfunction due to the generation of oxidative stress. Therefore, systemic iron levels must be tightly balanced. Here we focus on the regulatory role of the hepcidin/ferroportin circuitry as the major regulator of systemic iron homeostasis. We discuss how regulatory cues (e.g., iron, inflammation, or hypoxia) affect the hepcidin response and how impairment of the hepcidin/ferroportin regulatory system causes disorders of iron metabolism.
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