臨牀透析 Vol.29 No.13(2-1)


特集名 腎性貧血治療の新たな課題―ESA低反応性と鉄代謝異常
題名 鉄代謝 (1) ヘプシジンと鉄代謝
発刊年月 2013年 12月
著者 友杉 直久 金沢医科大学総合医学研究所先端医療研究領域加齢制御研究分野
【 要旨 】 生体は,少ない鉄を排泄せず保存し,回転させ再利用しながら,過剰に鉄を体内に吸収しないシステムをもっている.これは,生命の進化の過程で,危険な鉄をATP産生系への酸素の運搬や,酸化還元反応を触媒する酵素の活性中心として利用し始めた生命体が,その安全性を確保しながら,限られた貯蔵量のなかで鉄を利用する必要性に迫られ獲得したものである.近年の鉄代謝研究から,個体レベルではトランスフェリン受容体2・ヘプシジン・フェロポルチン系が,また細胞レベルではmRNA上のエレメントを介する転写後調節のIRE/IRP系が,分子レベルで鉄濃度の変化を感知してフィードバック制御していることが明らかになっており,鉄代謝の理解が深まっている.
Theme Problems to be solved in the therapy for renal anemia : Association of ESA hyporesponsiveness with dysregulated iron metabolism
Title Hepcidin and iron homeostasis
Author Naohisa Tomosugi Aging Research Unit, Department of Advanced Medicine, Medical Research Institute, Kanazawa Medical University
[ Summary ] Iron homeostasis in vertebrates requires coordination between erythrocytes which consume plasma iron and macrophages that supply iron into plasma. The main site of iron absorption is the small intestines and some iron is sequestered in the hepatocytes. However, most iron is recycled from hemoglobin-iron to plasma-iron via macrophage-phagocytosis in senescent erythrocytes. Iron is an essential element. Iron-containing proteins exert a variety of biological functions, including oxygen transport, cellular respiration with ATP production and enzymatic intermediaries. Since the properties of iron are inherently toxic and insolubil in aqueous solutions. As a result, iron concentration and distribution must be closely controlled. Such regulations are mediated by iron–sensing systems, including transferrin receptor 2, hepcidin and ferroportin, and iron-sensitive signaling pathways in cells, including the IRE/IRP system. This review provides a molecular perspective on iron metabolism for clinicians.
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