High iron stores and cardiovascular disease in systemic lupus erythematosus
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Dear Sir, We read with great interest the review by Frostegard [1] in a recent issue of the Journal of Internal Medicine on the association between cardiovascular disease and systemic lupus erythematosus (SLE). The author suggests several underlying mechanisms of this detrimental association, but does not consider the potential role of increased iron stores which can be observed in SLE. Anaemia is a feature of SLE and the serum iron level is generally low. However, serum iron is a marker of iron release into the plasma and utilization of iron incorporation in mainly haemoglobin, and may be not informative of the iron storage compart. In fact, in patients with SLE, the stored iron, as assessed with ferritin concentrations, may be elevated [2]. Furthermore, the serum ferritin level has been shown to be a useful marker of disease activity in patients with SLE [3]. The increased oxidative stress and enhanced lipid peroxidation observed in SLE [4] may generate superoxide radicals, which can cause the release of ferrous iron from ferritin [5]. Iron is a transitional metal that can catalyse the conversion of poorly reactive free radicals into highly active free radicals: this vicious circle can ultimately lead to the progression of atherosclerosis. In fact, serum ferritin has been shown to be a significant predictor of carotid atherosclerosis progression [6] and associated with an increased risk of ischaemic stroke [7]. Although serum ferritin also increases as an acute phase reactant, it has been demonstrated the absence of a strong relation between elevated ferritin levels and elevated inflammatory biomarkers [8]. Therefore, serum ferritin might be considered as an adjunctive risk factor for the development of cardiovascular disease in patients with SLE. No conflict of interest was declared.
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Lupus is a syndrome of broadly auto-immunological or inflammatory origin, with evidence for iron dysregulation.
“Lupus, or Systemic Lupus Erythematosus (SLE) [1275,1276] describes a syndrome, somewhat related to arthritis and rheumatism, of broadly auto-immunological or inflammatory origin”
From Iron behaving badly: inappropriate iron chelation as a major contributor to the aetiology of vascular and other progressive inflammatory and degenerative diseases (2009) · cites this paper as [1274]
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Cites
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- e-mail: lumasci@libero.it). Journal of Internal Medicine 2005; 258: 584 doi:10.1111/j.1365-2796.2005.01577.x 584 Ó 2005 Blackwell Publishing Ltd · DOI
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Iron, hepcidin, and increased atherosclerosis in systemic lupus erythematosus
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Self-citationHuang, R., Li, K., Wu, H., Wang, Y., Xu, Y., Jin, X., Du, Y., Wang, Y.-Y., Wang, J., Lu, Z.-W., et al. (2024) · Journal of Trace Elements in Medicine and Biology · doi:10.1016/j.jtemb.2024.127524 · Cited by 2 · see citing works
- Authors
- Mascitelli, L., & Pezzetta, F.
- Corresponding author
- Mascitelli, L.
- Venue
- Journal of Internal Medicine
- Publisher
- Wiley
- Published
- 2005-11-14
- Volume
- 258
- Issue
- 6
- Pages
- 584-584
- ISSN
- 0954-6820 (ISSN-L)
- 1365-2796
- OpenAlex
- W1967925787
- Cited by
- 3
- References
- 17
- Citations by year
- 2024: 1
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Keywords
- systemic lupus erythematosus, cardiovascular disease, iron stores, serum ferritin, atherosclerosis, oxidative stress, lipid peroxidation, ischemic stroke, carotid atherosclerosis, disease activity markers, anemia
- MeSH terms
- Cardiovascular Diseases, Ferritins, Humans, Iron, Lupus Erythematosus, Systemic
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