Physiological iron-handling system

The physiological iron-handling system is a complex, multi-organ network responsible for maintaining iron homeostasis, which is essential for oxygen transport, DNA synthesis, and mitochondrial function (Abbaspour et al., 2014). The system is primarily regulated by the hepcidin-ferroportin axis; hepcidin, a liver-produced hormone, acts as the master regulator by binding to and inducing the internalization of ferroportin, the only known cellular iron exporter (Ganz, 2010). This interaction controls the release of iron from duodenal enterocytes, recycling macrophages, and hepatocytes into the plasma, where it is transported by transferrin (StatPearls, 2023). Intracellularly, iron is safely sequestered within ferritin to prevent the generation of toxic free radicals via the Fenton reaction (NIH, 2023). Dysregulation of this system leads to significant clinical pathologies, including iron-deficiency anemia due to insufficient supply and hereditary hemochromatosis or transfusion-related iron overload due to excessive accumulation (Ganz, 2010). Pharmacological management involves iron salts for replacement, chelating agents to remove excess iron, and emerging therapies like hepcidin mimetics or HIF-PH inhibitors that modulate the body's endogenous regulatory responses (StatPearls, 2023).

Other names

Iron homeostasisIron metabolismHepcidin-ferroportin axisSystemic iron regulation

Modulation of iron levels through direct supplementation, chelation of excess iron, or pharmacological regulation of the hepcidin-ferroportin axis to control iron absorption and recycling.