Two to tango: Regulation of Mammalian iron metabolism
Open accessAbstract
Disruptions in iron homeostasis from both iron deficiency and overload account for some of the most common human diseases. Iron metabolism is balanced by two regulatory systems, one that functions systemically and relies on the hormone hepcidin and the iron exporter ferroportin, and another that predominantly controls cellular iron metabolism through iron-regulatory proteins that bind iron-responsive elements in regulated messenger RNAs. We describe how the two distinct systems function and how they "tango" together in a coordinated manner. We also highlight some of the current questions in mammalian iron metabolism and discuss therapeutic opportunities arising from a better understanding of the underlying biological principles.
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Serum ferritin is a marker of acute and chronic inflammatory conditions and can be markedly elevated in persons with average iron storage in many medical conditions.
“It is worth noting that SF is a marker of acute and chronic inflammatory conditions that can be markedly elevated in persons with average iron storage in many different medical conditions, such as rheumatoid arthritis, systemic lupus erythematosus, chronic kidney disease, hepatitis, excessive alcohol consumption, heart failure, acute infection, intestinal disorders such as coeliac disease, obesity”
From Defining Global Thresholds for Serum Ferritin: A Challenging Mission in Establishing the Iron Deficiency Diagnosis in This Era of Striving for Health Equity (2025) · cites this paper as [11]
The section “Plasma Iron: Key to Iron Overload and Iron Deficiency Anemias” (p. 1) says inflammatory conditions, infections, cancer, and liver disorders can increase serum ferritin, even though ferritin is used to assess iron stores. It does not establish that elevations are marked in people with average iron stores, or link serum ferritin to most of the specific conditions listed in the citing sentence. (LLM, conf=0.86)
Experimental — accuracy not yet measuredUnder physiological conditions iron recycling by macrophages accounts for approximately 95% of the daily needs of the metal for erythropoiesis and other physiological processes.
“Under physiological conditions iron recycling by macrophages accounts for approximately 95% of the daily needs of the metal for erythropoiesis and other physiological processes (Hentze et al., 2010; Pantopoulos et al., 2012).”
From Iron at the interface of immunity and infection (2014) · cites this paper as Hentze et al., 2010
Hepcidin expression is inhibited by iron deficiency, expansion of erythropoiesis, anemia/hypoxia, testosterone and possibly other factors.
“Hepcidin expression is inhibited by iron deficiency, expansion of erythropoiesis, anemia/hypoxia, testosterone and possibly other factors.1,47”
From Iron metabolism and iron disorders revisited in the hepcidin era (2020) · cites this paper as [1]
When intracellular iron is low, IRPs interact with conserved IREs in the UTRs of central genes accounting for iron homeostasis.
“When intracellular iron is low, IRPs interact with conserved iron-responsive elements (IREs) in the untranslated regions (UTRs) of central genes accounting for iron homeostasis [32,33].”
From Iron as a central player and promising target in cancer progression (2019) · cites this paper as [32]
The amount of the LIP is sensed by post-transcriptional mechanisms of IRP-1 and IRP-2 to fine-tune uptake, storage, and release of iron.
“The amount of the LIP is sensed by post-transcriptional mechanisms of cytosolic iron-regulated RNA binding proteins 1 and 2 (IRP-1 and IRP-2) to fine-tune uptake, storage, and release of iron.”
From Iron as a central player and promising target in cancer progression (2019) · cites this paper as [32]
Binding of IRPs to IREs in the 5'-UTR attenuates translation, whereas binding to IREs in the 3'-UTR stabilizes respective mRNAs and fosters translation.
“Binding of IRPs to IREs in the 5’-UTR attenuates translation, whereas binding to IREs in the 3’-UTR stabilizes respective mRNAs and fosters translation.”
From Iron as a central player and promising target in cancer progression (2019) · cites this paper as [32]
LPS stimulation increased binding of IRPs to a radiolabeled IRE RNA probe, indicative of reduced cytosolic Fe availability.
“However, gel retardation assays demonstrated that LPS stimulation increased binding of iron-regulatory proteins (IRPs) to a radiolabeled iron responsive element (IRE) RNA probe (Figure 3B), indicative of reduced cytosolic Fe availability (Hentze et al., 2010).”
From Ferritin-Mediated Iron Sequestration Stabilizes Hypoxia-Inducible Factor-1α upon LPS Activation in the Presence of Ample Oxygen (2015) · cites this paper as Hentze et al., 2010
Hepcidin promotes Fpn1 internalization and degradation.
“This appears to be the result of increased expression of the master iron regulator hepcidin, which promotes Fpn1 internalization and degradation (1, 36).”
From Dopamine Is a Siderophore-Like Iron Chelator That Promotes <i>Salmonella enterica</i> Serovar Typhimurium Virulence in Mice (2019) · cites this paper as [1]
Iron stores, particularly ferritin-associated iron in liver and spleen, can become depleted during chronic bleeding episodes, repetitive blood donations, helminth infestations, materno-fetal transfer, or growth.
“Due to this relatively inefficient process, iron stores, particularly ferritin-associated iron in liver and spleen, can become depleted during chronic bleeding episodes, repetitive blood donations, helminth infestations, through materno-fetal transfer, or during growth [5].”
From Iron deficiency or anemia of inflammation?: Differential diagnosis and mechanisms of anemia of inflammation (2016) · cites this paper as [5]
Peripheral cellular iron uptake mainly involves endocytosis of the diferric transferrin-transferrin receptor 1 complex, and iron is then transported from endosomes into the cell cytoplasm via divalent metal ion transporter 1.
“Peripheral cellular iron uptake mainly involves endocytosis of the diferric transferrin–transferrin receptor 1 (TFR1; panel) complex; iron is then transported from the endosomes into the cell cytoplasm via the divalent metal ion transporter 1 (DMT1; panel).”
From The role of iron in brain ageing and neurodegenerative disorders (2014) · cites this paper as [2]
Iron homoeostasis is needed to maintain normal physiological brain function.
“Iron homoeostasis is needed to maintain normal physiological brain function, whereas misregulation of iron homoeostasis can cause neurotoxicity through different mechanisms.”
From The role of iron in brain ageing and neurodegenerative disorders (2014) · cites this paper as [2]
Misregulation of iron homoeostasis can cause neurotoxicity through different mechanisms.
“Iron homoeostasis is needed to maintain normal physiological brain function, whereas misregulation of iron homoeostasis can cause neurotoxicity through different mechanisms.”
From The role of iron in brain ageing and neurodegenerative disorders (2014) · cites this paper as [2]
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Self-citationCa2+ channel blockers reverse iron overload by a new mechanism via divalent metal transporter-1
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Self-citationIron regulatory proteins secure mitochondrial iron sufficiency and function
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Bone Morphogenetic Protein Signaling Is Impaired in an Hfe Knockout Mouse Model of Hemochromatosis
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Neogenin inhibits HJV secretion and regulates BMP-induced hepcidin expression and iron homeostasis
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Self-citationHepcidin, the hormone of iron metabolism, is bound specifically to α-2-macroglobulin in blood
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SMAD7 controls iron metabolism as a potent inhibitor of hepcidin expression
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Self-citationBMP/Smad signaling is not enhanced in Hfe-deficient mice despite increased Bmp6 expression
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ER Stress-Inducible Factor CHOP Affects the Expression of Hepcidin by Modulating C/EBPalpha Activity
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Hepcidin, a key regulator of iron metabolism, is transcriptionally activated by p53
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Hepatocyte-targeted HFE and TFR2 control hepcidin expression in mice
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Oxidative stress and cell death in cells expressing L-ferritin variants causing neuroferritinopathy
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Voltage-gated Calcium Channels Provide an Alternate Route for Iron Uptake in Neuronal Cell Cultures
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Transferrin-a modulates hepcidin expression in zebrafish embryos
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Self-citationHepcidin Activation During Inflammation: Make It STAT
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“Binding to its ubiquitous receptor TFR1, transferrin delivers iron to cells through the wellknown endosomal cycle.(1) This function is crucial not only for erythropoiesis, but also for muscle(4) and for B- and Tlymphocytes, as highlighted by a TFR1 homozygous mutation that causes combined immunodeficiency with only mi…”
Self-citationIron Homeostasis and Ferroptosis in Human Diseases: Mechanisms and Therapeutic Prospects
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“Under physiological conditions iron recycling by macrophages accounts for approximately 95% of the daily needs of the metal for erythropoiesis and other physiological processes (Hentze et al., 2010; Pantopoulos et al., 2012).”
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Gut Microbiota and Iron: The Crucial Actors in Health and Disease
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Iron as a central player and promising target in cancer progression
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“When intracellular iron is low, IRPs interact with conserved iron-responsive elements (IREs) in the untranslated regions (UTRs) of central genes accounting for iron homeostasis [32,33].”
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17β-Estradiol Inhibits Iron Hormone Hepcidin Through an Estrogen Responsive Element Half-Site
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Self-citationmTOR regulates cellular iron homeostasis through tristetraprolin
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The Role of Iron in the Immune Response to Bacterial Infection
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Pharmacologic inhibition of hepcidin expression reverses anemia of chronic inflammation in rats
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“Pumping iron”—how macrophages handle iron at the systemic, microenvironmental, and cellular levels
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Ineffective erythropoiesis and regulation of iron status in iron loading anaemias
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Self-citationThe pleiotropic effects of erythropoietin in infection and inflammation
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Deletion of TMPRSS6 attenuates the phenotype in a mouse model of β-thalassemia
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Self-citationCoupling Heme and Iron Metabolism <i>via</i> Ferritin H Chain
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The Role of Iron in Cancer Progression
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Hypoxia induced downregulation of hepcidin is mediated by platelet derived growth factor BB
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Self-citationAnaemia in inflammatory rheumatic diseases
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“However, gel retardation assays demonstrated that LPS stimulation increased binding of iron-regulatory proteins (IRPs) to a radiolabeled iron responsive element (IRE) RNA probe (Figure 3B), indicative of reduced cytosolic Fe availability (Hentze et al., 2010).”
BackgroundSelf-citationIron regulatory proteins control a mucosal block to intestinal iron absorption
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“and, as a consequence, organisms have evolved sophisticated homeostatic mechanisms to tightly regulate the acquisition, utilization, storage and mobilization of Fe”
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“European research contributions European researchers have contributed identifying hepcidin, the key liver hormone regulating systemic iron homeostasis, defining its role in genetic iron-related disorders and clarifying how high hepcidin induces iron sequestration and iron-deficient erythropoiesis in ACD.(160) Our adva…”
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The Repair of Skeletal Muscle Requires Iron Recycling through Macrophage Ferroportin
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Dietary iron loading negatively affects liver mitochondrial function
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- Authors
- Hentze, M. W., Muckenthaler, M. U., Galy, B., & Camaschella, C.
- Affiliations
- Heidelberg University (DE)
- European Molecular Biology Laboratory (DE)
- Vita-Salute San Raffaele University (IT)
- Corresponding author
- Hentze, Matthias W.
- Venue
- Cell
- Publisher
- Elsevier BV
- Published
- 2010-07
- Volume
- 142
- Issue
- 1
- Pages
- 24-38
- ISSN
- 0092-8674 (ISSN-L)
- OpenAlex
- W2107704801
- Cited by
- 2,120
- References
- 111
- Citations by year
- 2026: 98 · 2025: 117 · 2024: 161 · 2023: 169 · 2022: 156 · 2021: 162 · 2020: 159 · 2019: 159 · 2018: 129 · 2017: 125 · 2016: 106 · 2015: 118 · 2014: 133 · 2013: 113 · 2012: 113
- FWCI
- 16.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Cell (publishedVersion)
- PubMed (publishedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, cc-by)
- Funders
- European Commission
- Deutsche Forschungsgemeinschaft
- Topics
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Ferroptosis and cancer prognosis
- Life Sciences › Neuroscience › Neurology › Neurological diseases and metabolism
- Keywords
- iron metabolism, iron homeostasis, hepcidin, ferroportin, iron regulatory proteins, iron-responsive element, iron deficiency, iron overload, therapeutic target
- MeSH terms
- Animals, Cell Physiological Phenomena, Humans, Iron, Anemia, Iron-Deficiency, Iron Overload, Antimicrobial Cationic Peptides, Hepcidins
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