Faculty of Medicine, Department of Physiology, University of Prishtina, Prishtina, Kosovo.
Acta Physiol (Oxf). 2020 Jan;228(1):e13324. doi: 10.1111/apha.13324. Epub 2019 Jun 19.
Highly active cardiomyocytes need iron for their metabolic activity. In physiological conditions, iron turnover is a delicate process which is dependent on global iron supply and local autonomous regulatory mechanisms. Though less is known about the autonomous regulatory mechanisms, data suggest that these mechanisms can preserve cellular iron turnover even in the presence of systemic iron disturbance. Therefore, activity of local iron protein machinery and its relationship with global iron metabolism is important to understand cardiac iron metabolism in physiological conditions and in cardiac disease. Our knowledge in this respect has helped in designing therapeutic strategies for different cardiac diseases. This review is a synthesis of our current knowledge concerning the regulation of cardiac iron metabolism. In addition, different models of cardiac iron dysmetabolism will be discussed through the examples of heart failure (cardiomyocyte iron deficiency), myocardial infarction (acute changes in cardiac iron turnover), doxorubicin-induced cardiotoxicity (cardiomyocyte iron overload in mitochondria), thalassaemia (cardiomyocyte cytosolic and mitochondrial iron overload) and Friedreich ataxia (asymmetric cytosolic/mitochondrial cardiac iron dysmetabolism). Finally, future perspectives will be discussed in order to resolve actual gaps in knowledge, which should be helpful in finding new treatment possibilities in different cardiac diseases.
高活性心肌细胞需要铁来进行代谢活动。在生理条件下，铁的周转是一个微妙的过程，依赖于全身的铁供应和局部自主调节机制。尽管关于自主调节机制的了解较少，但数据表明，即使存在系统性铁紊乱，这些机制也可以维持细胞内铁的周转。因此，了解局部铁蛋白机器的活性及其与全身铁代谢的关系，对于理解生理条件下和心脏疾病中的心脏铁代谢是很重要的。我们在这方面的知识有助于设计针对不同心脏疾病的治疗策略。这篇综述是对我们目前关于心脏铁代谢调节的知识的综合。此外，还将通过心力衰竭（心肌细胞铁缺乏）、心肌梗死（心脏铁周转的急性变化）、多柔比星诱导的心脏毒性（线粒体中的心肌细胞铁过载）、地中海贫血（心肌细胞胞浆和线粒体铁过载）和弗里德赖希共济失调（不对称的胞浆/线粒体心脏铁代谢紊乱）的例子，讨论不同的心脏铁代谢紊乱模型。最后，将讨论未来的展望，以解决知识的实际差距，这有助于在不同的心脏疾病中找到新的治疗可能性。
