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Molecular basis of iron-loading disorders

Published online by Cambridge University Press:  08 November 2010

Deepak Darshan ,
David M. Frazer  and
Gregory J. Anderson
Deepak Darshan
Affiliation:
Iron Metabolism Laboratory, Queensland Institute of Medical Research, Brisbane, Queensland, Australia.
David M. Frazer
Affiliation:
Iron Metabolism Laboratory, Queensland Institute of Medical Research, Brisbane, Queensland, Australia.
Gregory J. Anderson*
Affiliation:
Iron Metabolism Laboratory, Queensland Institute of Medical Research, Brisbane, Queensland, Australia.
*
*Corresponding author: Gregory J. Anderson, Iron Metabolism Laboratory, Queensland Institute of Medical Research, Royal Brisbane Hospital, Brisbane, Queensland 4029, Australia. E-mail: [email protected]
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Abstract

Iron-loading disorders (haemochromatosis) represent an important class of human diseases. Primary iron loading results from inherited disturbances in the mechanisms regulating intestinal iron absorption, such that excess iron is taken up from the diet. Body iron load can also be increased by repeated blood transfusions (secondary iron loading), usually as part of the treatment for various haematological disorders. In these syndromes, an element of enhanced iron absorption is also often involved. The central regulator of body iron trafficking is the liver-derived peptide hepcidin. Hepcidin limits iron entry into the plasma from macrophages, intestinal enterocytes and other cells by binding to the sole iron-export protein ferroportin, and facilitating its removal from the plasma membrane. Mutations in hepcidin or its upstream regulators (HFE, TFR2, HFE2 and BMP6) lead to reduced or absent hepcidin expression and a concomitant increase in iron absorption. Mutations in ferroportin that prevent hepcidin binding produce a similar result. Increased ineffective erythropoiesis, which often characterises erythrocyte disorders, also leads to reduced hepcidin expression and increased absorption. Recent advances in our understanding of hepcidin and body iron homeostasis provide the potential for a range of new diagnostic and therapeutic tools for haemochromatosis and related conditions.

Type
Review Article
Information
Expert Reviews in Molecular Medicine , Volume 12 , January 2010 , e36
Copyright
Copyright © Cambridge University Press 2010

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References

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Further reading, resources and contacts

Weiss, G. (2010) Genetic mechanisms and modifying factors in hereditary hemochromatosis. Nature Reviews Gastroenterology and Hepatology 7, 50-58CrossRefGoogle ScholarPubMed
Adams, P.C. and Barton, J.C. (2010) How I treat hemochromatosis. Blood 22, 317-325CrossRefGoogle Scholar
Pietrangelo, A. (2010) Hereditary hemochromatosis: pathogenesis, diagnosis, and treatment. Gastroenterology 139, 393-408CrossRefGoogle ScholarPubMed