Systemic iron metabolism

Systemic iron metabolism is the highly regulated physiological process responsible for maintaining iron homeostasis by balancing iron absorption, transport, storage, and recycling. The system is primarily controlled by the hepatic hormone hepcidin, which acts as a master regulator by binding to and inducing the degradation of ferroportin, the only known cellular iron exporter. This interaction determines the amount of iron released into the plasma from duodenal enterocytes, recycling macrophages, and storage hepatocytes. Iron is a critical cofactor for hemoglobin-mediated oxygen transport, mitochondrial energy production, and DNA synthesis; however, its ability to participate in Fenton chemistry means that excess free iron can lead to significant oxidative damage. Dysregulation of this system is central to the pathogenesis of various disorders, including iron deficiency anemia, hereditary hemochromatosis, and anemia of inflammation. Therapeutic strategies targeting this system include iron chelators to remove excess iron, hepcidin modulators to treat iron-restricted anemias or overload, and direct iron supplementation to replenish depleted stores.

Other names

Iron homeostasisSystemic iron regulationHepcidin-ferroportin axisIron metabolism

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