Iron dysregulation in beta-thalassemia
10.1016/j.apjtm.2016.07.035
- Author:
Kamonlak LEECHAROENKIAT
1
;
Pathrapol LITHANATUDOM
2
;
Wannapa SORNJAI
3
;
Duncan R. SMITH
3
Author Information
1. Department of Clinical Microscopy, Faculty of Allied Health Sciences, Chulalongkorn University
2. Department of Biology, Faculty of Science, Chiang Mai University
3. Molecular Pathology Laboratory, Institute of Molecular Biosciences, Mahidol University
- Publication Type:Journal Article
- Keywords:
Beta-thalassemia;
Ferroportin;
Hepcidin;
Iron overload
- From:
Asian Pacific Journal of Tropical Medicine
2016;9(11):1035-1043
- CountryChina
- Language:Chinese
-
Abstract:
Iron deficiency anemia and iron overload conditions affect more than one billion people worldwide. Iron homeostasis involves the regulation of cells that export iron into the plasma and cells that utilize or store iron. The cellular iron balance in humans is primarily mediated by the hepcidin–ferroportin axis. Ferroportin is the sole cellular iron export protein, and its expression is regulated transcriptionally, post-transcriptionally and post-translationally. Hepcidin, a hormone produced by liver cells, post-translationally regulates ferroportin expression on iron exporting cells by binding with ferroportin and promoting its internalization by endocytosis and subsequent degradation by lysosomes. Dysregulation of iron homeostasis leading to iron deposition in vital organs is the main cause of death in beta-thalassemia patients. Beta-thalassemia patients show marked hepcidin suppression, ineffective erythropoiesis, anemia and iron overload. Beta-thalassemia is common in the Mediterranean region, Southeast Asia and the Indian subcontinent, and the focus of this review is to provide an update on the factors mediating hepcidin related iron dysregulation in beta-thalassemia disease. Understanding this process may pave the way for new treatments to ameliorate iron overloading and improve the long term prognosis of these patients.
