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Research on Iron Metabolism and Related Diseases

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: closed (30 May 2023) | Viewed by 4140

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Departamento de Ciencias Básicas de Ciencias de la Salud, Universitat Internacional de Catalunya, Immaculada, 22, 08127 Barcelona, Spain
Interests: iron metabolism; iron regulation; iron diseases; RNA biology; human genetics
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Special Issue Information

Dear Colleagues,

Iron is an important micronutrient that is most known for being the cornerstone of the hematopoietic process. However, the role of iron expands beyond red blood cell production as it is part of iron-containing proteins, in the form of heme groups, Fe/S clusters, or directly as iron proteins. Therefore, iron is involved in many other vital cellular processes and responses, such as oxidation–reduction reactions, mitochondrial respiratory chain, neurotransmitters production, DNA/RNA synthesis, inflammation, infection, and so on.

In mammals, iron levels are sensed and regulated by the liver-secreted hormone hepcidin. At a cellular level, iron homeostasis is controlled by IRP1 and IRP2, two iron-sensing proteins that control the expression of the genes involved in iron uptake, storage, and utilization at a post-transcriptional level.

Iron metabolism dysregulation leads to iron-related diseases including different forms of acquired or inherited anemias, i.e., myelodysplastic syndrome, congenital sideroblastic anemia, congenital dyserythropoietic anemia, atransferrinemia, aceruloplasminemia, IRIDA (iron-refractory iron deficiency anemia), and other types of iron-related anemias; acquired or hereditary iron-overload conditions, such as hereditary hemochromatosis, iron-related neurodegenerative diseases, or ataxias; and diseases involving dysfunctional Fe/S cluster proteins, such as multiple mitochondrial dysfunction syndromes.

Great efforts have been made to reveal the genetic causes of most of these diseases, as well as their underlying molecular regulatory mechanisms. In the future, we will certainly maintain this progress, uncovering additional novel genes involved in iron-related diseases and advancing in our knowledge concerning iron regulation in health and disease, all of which will significantly contribute to the development of new therapies.

This Special Issue “Research on Iron Metabolism and Related Diseases” is focused on contributing works including genetic, molecular, bioinformatics, and clinical studies on iron homeostasis, genetic iron regulation, and iron-related diseases. With the help of your contribution, we hope to reach a better understanding of the normal and aberrant regulation of iron homeostasis and its diseases, leading to better diagnostics and treatments for affected patients with these conditions.

Prof. Dr. Mayka Sánchez Fernández
Guest Editor

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Published Papers (2 papers)

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19 pages, 4762 KiB  
Article
New Cases and Mutations in SEC23B Gene Causing Congenital Dyserythropoietic Anemia Type II
by Melina Mara Musri, Veronica Venturi, Xènia Ferrer-Cortès, Lídia Romero-Cortadellas, Gonzalo Hernández, Pilar Leoz, María Pilar Ricard Andrés, Marta Morado, María del Carmen Fernández Valle, David Beneitez Pastor, Ana Ortuño Cabrero, Maite Moreno Gamiz, Leonor Senent Peris, Amanda Isabel Perez-Valencia, Santiago Pérez-Montero, Cristian Tornador and Mayka Sánchez
Int. J. Mol. Sci. 2023, 24(12), 9935; https://doi.org/10.3390/ijms24129935 - 9 Jun 2023
Cited by 3 | Viewed by 1505
Abstract
Congenital dyserythropoietic anemia type II (CDA II) is an inherited autosomal recessive blood disorder which belongs to the wide group of ineffective erythropoiesis conditions. It is characterized by mild to severe normocytic anemia, jaundice, and splenomegaly owing to the hemolytic component. This often [...] Read more.
Congenital dyserythropoietic anemia type II (CDA II) is an inherited autosomal recessive blood disorder which belongs to the wide group of ineffective erythropoiesis conditions. It is characterized by mild to severe normocytic anemia, jaundice, and splenomegaly owing to the hemolytic component. This often leads to liver iron overload and gallstones. CDA II is caused by biallelic mutations in the SEC23B gene. In this study, we report 9 new CDA II cases and identify 16 pathogenic variants, 6 of which are novel. The newly reported variants in SEC23B include three missenses (p.Thr445Arg, p.Tyr579Cys, and p.Arg701His), one frameshift (p.Asp693GlyfsTer2), and two splicing variants (c.1512-2A>G, and the complex intronic variant c.1512-3delinsTT linked to c.1512-16_1512-7delACTCTGGAAT in the same allele). Computational analyses of the missense variants indicated a loss of key residue interactions within the beta sheet and the helical and gelsolin domains, respectively. Analysis of SEC23B protein levels done in patient-derived lymphoblastoid cell lines (LCLs) showed a significant decrease in SEC23B protein expression, in the absence of SEC23A compensation. Reduced SEC23B mRNA expression was only detected in two probands carrying nonsense and frameshift variants; the remaining patients showed either higher gene expression levels or no expression changes at all. The skipping of exons 13 and 14 in the newly reported complex variant c.1512-3delinsTT/c.1512-16_1512-7delACTCTGGAAT results in a shorter protein isoform, as assessed by RT-PCR followed by Sanger sequencing. In this work, we summarize a comprehensive spectrum of SEC23B variants, describe nine new CDA II cases accounting for six previously unreported variants, and discuss innovative therapeutic approaches for CDA II. Full article
(This article belongs to the Special Issue Research on Iron Metabolism and Related Diseases)
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21 pages, 1321 KiB  
Review
Markers of Iron Metabolism and Outcomes in Patients with Heart Failure: A Systematic Review
by Simrat Dhaliwal and Andreas P. Kalogeropoulos
Int. J. Mol. Sci. 2023, 24(6), 5645; https://doi.org/10.3390/ijms24065645 - 15 Mar 2023
Cited by 4 | Viewed by 2311
Abstract
Iron deficiency (ID) in conjunction with heart failure (HF) poses a challenge for clinicians and is associated with worse HF outcomes. Treatment of ID with IV iron supplementation for patients with HF has demonstrated benefits in quality of life (QoL) and HF-related hospitalizations. [...] Read more.
Iron deficiency (ID) in conjunction with heart failure (HF) poses a challenge for clinicians and is associated with worse HF outcomes. Treatment of ID with IV iron supplementation for patients with HF has demonstrated benefits in quality of life (QoL) and HF-related hospitalizations. The aim of this systematic review was to summarize the evidence linking iron metabolism biomarkers with outcomes in patients with HF to assist in the optimal use of these biomarkers for patient selection. A systematic review of observational studies in English from 2010 to 2022 was conducted using PubMed, with keywords of “Heart Failure” and respective iron metabolism biomarkers (“Ferritin”, “Hepcidin”, “TSAT”, “Serum Iron”, and “Soluble Transferrin Receptor”). Studies pertaining to HF patients, with available quantitative data on serum iron metabolism biomarkers, and report of specific outcomes (mortality, hospitalization rates, functional capacity, QoL, and cardiovascular events) were included, irrespective of left ventricular ejection fraction (LVEF) or other HF characteristics. Clinical trials of iron supplementation and anemia treatment were removed. This systematic review was conducive to formal assessment of risk of bias via Newcastle-Ottawa Scale. Results were synthesized based on their respective adverse outcomes and iron metabolism biomarker(s). Initial and updated searches identified 508 unique titles once duplicates were removed. The final analysis included 26 studies: 58% focused on reduced LVEF; age range was 53–79 years; males composed 41–100% of the reported population. Statistically significant associations of ID were observed with all-cause mortality, HF hospitalization rates, functional capacity, and QoL. Increased risk for cerebrovascular events and acute renal injury have also been reported, but these findings were not consistent. Varying definitions of ID were utilized among the studies; however, most studies employed the current European Society of Cardiology criteria: serum ferritin < 100 ng/mL or the combination of ferritin between 100–299 ng/mL and transferrin saturation (TSAT) < 20%. Despite several iron metabolism biomarkers demonstrating strong association with several outcomes, TSAT better predicted all-cause mortality, as well as long-term risk for HF hospitalizations. Low ferritin was associated with short-term risk for HF hospitalizations, worsening functional capacity, poor QoL, and development of acute renal injury in acute HF. Elevated soluble transferrin receptor (sTfR) levels were associated with worse functional capacity and QoL. Finally, low serum iron was significantly associated with increased risk for cardiovascular events. Considering the lack of consistency among the iron metabolism biomarkers for association with adverse outcomes, it is important to incorporate additional biomarker data, beyond ferritin and TSAT, when assessing for ID in HF patients. These inconsistent associations question how best to define ID to ensure proper treatment. Further research, potentially tailored to specific HF phenotypes, is required to optimize patient selection for iron supplementation therapy and appropriate targets for iron stores replenishment. Full article
(This article belongs to the Special Issue Research on Iron Metabolism and Related Diseases)
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