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Intestinal Iron Absorption

Dietary iron absorption takes place at the apical membrane of mature enterocytes. In hereditary hemochromatosis, increased iron absorption leads to the gradual accumulation of iron to levels that eventually become toxic. The iron regulatory protein HFE has been implicated in this process (1).

Enterocyte iron absorption mechanisms

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DMT1

Ferritin

Ferroportin

Transferrin receptor

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Cellular Mechanisms

Intestinal Iron Absorption

Hepatocellular Iron Uptake and Storage

Reticuloendothelial Iron Storage

In both primary
and secondary iron overload, serum
ferritin >1000 mcg/L
is associated with worsened prognosis.

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After its enzymatic reduction from Fe+3 to Fe+2, iron is imported into the cell by the divalent metal transporter protein (2). Iron can either be stored within the cell as ferritin, or transferred into the blood at the basolateral membrane by ferroportin (IREG1) (3). Plasma-borne iron binds to transferrin, and is available for distribution via the blood.

How hepatocytes efficiently acquire and store iron

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References

* (1) Pietrangelo A, Camaschella C, Molecular genetics and control of iron metabolism in hemochromatosis. Haematologica. 1998;83(5):456-61.
* (2) Andrews NC, The iron transporter dmt1. Int J Biochem Cell Biol. 1999;31(10):991-4.
* (3) Zoller H, Theurl I, Koch R, et al., Mechanisms of iron mediated regulation of the duodenal iron transporters divalent metal transporter 1 and ferroportin 1. Blood Cells Mol Dis. 2002;29(3):488-97.

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Intestinal Iron Absorption

DMT1

Ferritin

Ferroportin

Transferrin receptor

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Consider treatment at Serum Ferritin

>1000 mcg/L

How hepatocytes efficiently acquire and store iron

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