哺乳动物铁稳态分子机制研究进展

铁是机体必需微量元素,参与机体合成血红蛋白、肌红蛋白及多种酶的组成和功能发挥,对维持生命和健康至关重要。近四分之一的世界人口遭受铁缺乏或缺铁性贫血的威胁。此外,部分人群还存在铁过载问题,以脏器铁离子蓄积为主要病理改变的遗传性血色病,其在欧美发病率高达1/200,在中国也有报道。血色病后期多诱发肝脏、胰腺及心脏的功能衰退。铁过少或过多对健康都会造成严重危害,机体需要复杂而精密的调控体系维持铁稳态平衡。铁代谢主要包括小肠吸收、肝脏储存、血液转运、巨噬细胞再循环以及周身细胞利用。过去十多年是铁代谢研究的黄金时期,先后发现众多铁稳态代谢相关基因。该文综述了近年来哺乳动物铁代谢领域的研究进展,并对铁稳态代谢中存在的问题进行了初步讨论,为理解和进一步深入研究铁代谢分子机制提供参考。     

小鼠模型在铁代谢研究中的应用

铁代谢在维持生命活动中至关重要,机体铁代谢紊乱会导致贫血和人类遗传性血色病等诸多疾病,对人体健康造成危害。在铁代谢研究领域,小鼠模型具有人群及细胞模型所不具备的优势,可以最准确的表现相应基因及通路在铁代谢调控中的生理作用。利用基因敲除及转基因小鼠模型,许多铁代谢相关的基因及调控通路被发现,有助于深入了解铁稳态调控的分子机制。这些小鼠模型为治疗铁代谢紊乱相关疾病潜在药物的开发和评估提供了理想的平台。     

Hepcidin研究进展

Hepcidin是肝脏特异性表达的一种小分子抗菌肽,是铁代谢的负调节激素。与炎症性贫血、遗传性血色沉着病等疾病的发病机制密切相关。证据显示,Hepcidin直接抑制肠上皮细胞铁吸收和诱导单核巨噬细胞铁滞留。同时,Hepcidin还具有广谱抗菌活性,与固有免疫密切相关。铁超载、感染、炎症及细胞因子可诱导Hepcidin表达,而贫血和缺氧则抑制其表达。Hepcidin的发现及其相关的铁离子运输机制的研究,将为铁离子吸收及分配的铁稳态调节和炎症性贫血、遗传性血色沉着病中的铁代谢障碍的分子机制探索开辟新的途径。本文就Hepcidin的分子特征、表达调控及生物学功能等方面研究进展进行综述。     

脑铁代谢和神经变性性疾病

最近关于脑铁代谢研究的新成果,尤其是与脑铁转运、储存、调节相关的某些突变基因的发现,足以得出以下结论,即异常增高的脑铁至少是部份神经变性疾病的起始原因。研究显示,脑铁过量积聚主要是由于遗传性和非遗传性因素所引起的某些服铁代谢蛋白功能异常或表达失控。正是异常增高的脑铁触发一系列病理反应,最终导致神经为性性疾病病人服神经元死亡。本文简要叙述了目前对服铁分布、功能和脑铁代谢蛋白的认识,讨论了内铁转运机制以及服铁和神经变性性疾病之间的关系研究的新进展。     

铁过载引起的疾病：一种“沉默”的疾病

铁是人体生命必需的微量元素,但摄入过多也会对身体健康造成危害。在广大公众心目中．往往只认识到铁提供给人体营养价值的一面,而忽视了铁过量的潜在危害。铁过量会影响心脏、肝脏、内分泌系统和其他器官的正常功能。介绍了血色病、神经退行性疾病、癌症等与铁过载有关的疾病,以期引起人们对铁代谢的全面认识。     

Hepcidin在哺乳类及鱼类中的表达和作用

Hepcidin也称为铁调素,是肝脏特异性表达的一种阳离子小分子抗菌肽,具有抑制多种细菌、真菌、病毒和原生动物生长繁殖的作用,是机体天然免疫的一种效应分子;同时也是一种信号分子,参与机体铁代谢,通过直接抑制肠上皮细胞铁吸收和单核巨噬细胞铁释放调节机体铁平衡,与炎症性贫血、遗传性血色素沉着病等铁代谢紊乱性疾病的发病机制密切相关。脂多糖（LPS）、铁超载和病原体可诱导hepcidin表达,而贫血和缺氧可下调其表达。目前,鱼类hepcidin的研究也成为热点,但主要集中在hepcidin的抗菌活性方面,有关其在鱼类铁代谢方面的功能仍需要进一步研究。     

铁转运刺激因子研究进展

铁转运刺激因子 (stimulatorofFetransport,SFT)是近年新发现的一个重要的铁代谢蛋白。SFT是一种跨膜糖蛋白 ,含 6个跨膜区域 ,在第一个细胞内环中含有功能上十分重要的REIHE序列。它广泛分布于各组识 ,其主要功能是促进转铁蛋白结合铁和非转铁蛋白结合铁的转运。SFT的基因表达和功能发挥受铁的调控。遗传性血色素沉着病人的肝脏内SFTmRNA的表达显著增加 ,因而SFT超表达可能与遗传性血色素沉着病的形成有关     

铁死亡与缺血性脑卒中

铁死亡是一种铁代谢异常、脂质过氧化物累积构成的可调节性新型细胞死亡方式。缺血性脑卒中是全球第二大常见的脑血管疾病,病死率、致残率、复发率极高,其发生伴随着大量神经元死亡。现有研究证明,缺血性脑卒中发病机制与铁死亡关系密切。缺血性脑卒中损伤中出现的细胞内铁水平升高、脂质过氧化物增多和抗氧化能力下降的现象与铁依赖性非凋亡形式的铁死亡相一致。因此,阐明铁死亡在缺血性脑卒中的发生机制,有利于为其临床治疗提供新靶点。本文将从铁代谢、脂质代谢、氨基酸代谢、活性氧生成的调控等方面论述铁死亡发生的调节机制,着重探讨铁死亡发生在缺血性脑卒中的病理生理机制,期望以铁死亡为切入点,为缺血性脑卒中的临床治疗提供参考。     

铁调素调控与铁代谢相关疾病研究进展

铁离子对所有生物来说都是必需元素。人体组织中的铁含量被精确调控,以确保体内铁始终处于正常生理水平。多种疾病可引起人体铁代谢失调,如血色病、慢性丙型肝炎和酒精性肝病等。许多分子参与了铁调控,其中铁调素是机体铁稳态的中心调控分子。研究铁调素有助于加深人们对人体铁失调分子机制的深入认识。初步讨论了铁调素调控与铁代谢相关疾病的关系,为理解铁代谢疾病提供线索和新的临床诊断和治疗依据。     

细胞质及线粒体ferritin与铁代谢

铁是机体代谢所必需的微量元素之一。近年来,铁在机体内的代谢越来越受到人们的重视。维持体内铁的平衡,对保证机体的正常生理功能显得极为重要。胞质铁蛋白（cytosolic ferrifin,CFt）是细胞内重要的调节铁平衡的因子之一。而近年发现的线粒体铁蛋白（mitochondrial ferritin,MtFt）是一种定位在线粒上、和铁代谢密切相关的蛋白,具有组织受限性表达的特点,它在结构和功能上与胞质铁蛋白相比有一定的相似性,但是由于其mRNA上没有铁调控元件,它的表达不直接受铁调节蛋白调控,所以其确切功能及表达机制还未完全明了,因此,近年来有不少人开展了这方面的研究。对线粒体铁蛋白的深入研究将极大地丰富人们对铁在亚细胞水平上的代谢机制和功能的认识。文章介绍了细胞质铁蛋白的调控机制以及线粒体铁蛋白的结构、功能、表达及与铁代谢的关系。     

Hemochromatosis and the enigma of misplaced iron: Implications for infectious disease and survival

The mystery surrounding the apparent lack of iron within the macrophages of individuals with hereditary hemochromatosis, a condition of excessive uptake of dietary iron, has yet to be fully explained. We have suggested that iron deficiency of macrophages in people with hereditary hemochromatosis mutations is associated with increased resistance to infection by Yersinia and other intracellular pathogens, a selection pressure resulting in unusually high current population frequencies of hereditary hemochromatosis mutations. Such selection pressure has been called Epidemic Pathogenic Selection (EPS). In support of the theory of EPS, a considerable number of virulent species of bacteria multiply mainly in iron-rich macrophages of their mammalian hosts. Among these fastidious pathogens are strains of Chlamydia, Coxiella, Francisella, Legionella, Mycobacterium, Salmonella and Yersinia. Iron deficiency of macrophages of persons with hereditary hemochromatosis gene mutations may result in increased resistance to members of these bacterial pathogens. People with genes that result in hereditary hemochromatosis may be protected against coronary artery disease associated with Chlamydia and Coxiella infection in the absence of iron overload. In the clinical setting, when a patient appears to be iron deficient, the reason for this should be carefully evaluated. Iron supplementation may adversely affect the health of individuals who have mounted an acute phase response to infection, injury or stress, or who carry genes predisposing them to iron overload disorders.     

海帕西啶铁调节和血色素沉着

血色素沉着是一种血浆铁沉积过多而导致的器官损伤性疾病,多种铁调节基因如HFE、HJV、HAMP和TfR2等的突变均可导致该病的发生,其中HAMP是最为重要的一种。HAMP基因编码一种名为海帕西啶的小肽,是小肠铁重吸收和巨噬细胞铁释放的负调节因子。海帕西啶含量的减少将导致血清铁过负荷和血色素沉着的发生,HFE、HJV和TfR2等基因可影响海帕西啶的表达,从而使海帕西啶成为血色素沉着的中央调节者。这些研究对血色素沉着发生机制的理解及其诊断和治疗具有重要意义。     

Iron-independent specific protein expression pattern in the liver of HFE-deficient mice

Hereditary hemochromatosis type I is an autosomal-recessive iron overload disease associated with a mutation in HFE gene. The most common mutation, C282Y, disrupts the disulfide bond necessary for the association of HFE with beta-2-microglobulin and abrogates cell surface HFE expression. HFE-deficient mice develop iron overload indicating a central role of the protein in the pathogenesis of hereditary hemochromatosis type I. However, despite significant effort, the role of the HFE protein in iron metabolism is still unknown. To shed a light on the molecular mechanism of HFE-related hemochromatosis we studied protein expression changes elicited by HFE-deficiency in the liver which is the organ critical for the regulation of iron metabolism. We undertook a proteomic study comparing protein expression in the liver of HFE deficient mice with control animals. We compared HFE-deficient animals with control animals with identical iron levels obtained by dietary treatment to identify changes specific to HFE deficiency rather than iron loading. We found 11 proteins that were differentially expressed in the HFE-deficient liver using two-dimensional electrophoresis and mass spectrometry identification. Of particular interest were urinary proteins 1, 2 and 6, glutathione-S-transferase P1, selenium binding protein 2, sarcosine dehydrogenase and thioredoxin-like protein 2. Our data suggest possible involvement of lipocalins, TNF-alpha signaling and PPAR alpha regulatory pathway in the pathogenesis of hereditary hemochromatosis and suggest future targeted research addressing the roles of the identified candidate genes in the molecular mechanism of hereditary hemochromatosis.     

Transferrin receptor 2 is emerging as a major player in the control of iron metabolism

Our knowledge of mammalian iron metabolism has advanced dramatically over recent years. Iron is an essential element for virtually all living organisms. Its intestinal absorption and accurate cellular regulation is strictly required to ensure the coordinated synthesis of the numerous iron-containing proteins involved in key metabolic processes, while avoiding the uptake of excess iron that can lead to organ damage. A range of different proteins exist to ensure this fine control within the various tissues of the body. Among these proteins, transferrin receptor (TFR2) seems to play a key role in the regulation of iron homeostasis. Disabling mutations in TFR2 are responsible for type 3 hereditary hemochromatosis (Type 3 HH). This review describes the biological properties of this membrane receptor, with a particular emphasis paid to the structure, function and cellular localization. Although much information has been garnered on TFR2, further efforts are needed to elucidate its function in the context of the iron regulatory network.     

Defective trafficking and localization of mutated transferrin receptor 2: implications for type 3 hereditary hemochromatosis

Transferrin receptor 2 (TfR2), a homologue of transferrin receptor 1 (TfR1), is a key molecule involved in the regulation of iron homeostasis. Mutations in TfR2 result in iron overload with similar features to HFE-associated hereditary hemochromatosis. The precise role of TfR2 in iron metabolism and the functional consequences of disease-causing mutations have not been fully determined. We have expressed wild-type and various mutant forms of TfR2 that are associated with human disease in a mouse liver cell line. Intracellular and surface analysis shows that all the TfR2 mutations analyzed cause the intracellular retention of the protein in the endoplasmic reticulum, whereas the wild-type protein is expressed in endocytic structures and at the cell surface. Our results indicate that the majority of mutations that cause type 3 hereditary hemochromatosis are a consequence of the defective localization of the protein.     

Hereditary hemochromatosis: an opportunity for gene therapy

Levels of body iron should be tightly controlled to prevent the formation of oxygen radicals, lipoperoxidation, genotoxicity, and the production of cytotoxic cytokines, which result in damage to a number of organs. Enterocytes in the intestinal villae are involved in the apical uptake of iron from the intestinal lumen: iron is further exported from the cells into the circulation. The apical divalent metal transporter-1 (DMT1) transports ferrous iron from the lumen into the cells, while the basolateral transporter ferroportin extrudes iron from the enterocytes into the circulation. Patients with hereditary hemochromatosis display an accelerated transepithelial uptake of iron, which leads to body iron accumulation that results in cirrhosis, hepatocellular carcinoma, pancreatitis, and cardiomyopathy. Hereditary hemochromatosis, a recessive genetic condition, is the most prevalent genetic disease in Caucasians, with a prevalence of one in 300 subjects. The majority of patients with hereditary hemochromatosis display mutations in the gene coding for HFE, a protein that normally acts as an inhibitor of transepithelial iron transport. We discuss the different control points in the homeostasis of iron and the different mutations that exist in patients with hereditary hemochromatosis. These control sites may be influenced by gene therapeutic approaches; one general therapy for hemochromatosis of different etiologies is the inhibition of DMT1 synthesis by antisense-generating genes, which has been shown to markedly inhibit apical iron uptake by intestinal epithelial cells. We further discuss the most promising strategies to develop gene vectors and deliver them into enterocytes.     

Inactivation of the murine Transferrin Receptor 2 gene using the Cre recombinase: loxP system

Transferrin Receptor 2 (TfR2) is a key molecule involved in the regulation of iron homeostasis. Mutations in TfR2 lead to type 3 hemochromatosis in humans. We have developed mice with a targeted deletion of TfR2. The Cre-recombinase:loxP system used to create the mice allows both full deletion and tissue-specific deletion of TfR2. The development of these mice will provide new models for type 3 hemochromatosis and assist in determining the role of TfR2 in iron metabolism.     

Icariin protects against iron overload-induced bone loss via suppressing oxidative stress

Iron overload is common in patients with diseases such as hemoglobinopathies, hereditary hemochromatosis or elderly men and postmenopausal women. This disorder is frequently associated with bone loss and recently has been considered as an independent risk factor for osteoporosis. By excess reactive oxygen species (ROS) production through Fenton reaction, iron could induce osteoblast apoptosis, inhibit osteoblast osteogenic differentiation. Moreover, Iron could also promote osteoclasts differentiation and bone absorption. The goal of the study is to investigate whether icariin could reverse iron overload-induced bone loss in vitro and in vivo. Icariin is the major active ingredient of Herba Epimedii and has antioxidant, antiosteoporosis functions. In the current study, we demonstrated that oral administration of icariin significantly prevented bone loss in iron overloaded mice. Icariin could protect against iron overload-induced mitochondrial membrane potential dysfunction and ROS production, promote osteoblast survival and reverse the reduction of Runx2, alkaline phosphatase, and osteopontin expression induced by iron overload. Icariin also inhibited osteoclasts differentiation and function. Moreover, we also found that icariin remarkably reduced iron accumulation in bone marrow, suggesting that icariin has the ability to regulate systemic iron metabolism in vivo. These results indicated that icariin could be a potential natural resource for developing medicines to prevent or treat iron overload-induced osteoporosis.     

Iron Metabolism in the Reticuloendothelial System

Comprised mainly of monocytes and tissue macrophages, the reticuloendothelial system (RES) plays two major roles in iron metabolism: it recycles iron from senescent red blood cells and it serves as a large storage depot for excess iron. Although iron recycling by the RES represents the largest pathway of iron efflux in the body, the precise mechanisms involved have remained elusive. However, studies characterizing the function and regulation of Nramp1, DMT1, HFE, FPN1, CD163, and hepcidin are rapidly expanding our knowledge of the molecular aspects of RE iron handling. This review summarizes fundamental physiological and biochemical aspects of iron metabolism in the RES and focuses on how recent studies have advanced our understanding of these areas. Also discussed are novel insights into the molecular mechanisms contributing to the abnormal RE iron metabolism characteristic of hereditary hemochromatosis and the anemia of chronic disease.