Lakhal-Littleton Samira
Department of Physiology, Anatomy & Genetics, University of Oxford, Parks Road, Oxford OX1 3PT, UK.
Pharmaceuticals (Basel). 2019 Aug 28;12(3):125. doi: 10.3390/ph12030125.
Iron deficiency is the most common nutritional disorder in the world. It is prevalent amongst patients with cardiovascular disease, in whom it is associated with worse clinical outcomes. The benefits of iron supplementation have been established in chronic heart failure, but data on their effectiveness in other cardiovascular diseases are lacking or conflicting. Realising the potential of iron therapies in cardiovascular disease requires understanding of the mechanisms through which iron deficiency affects cardiovascular function, and the cell types in which such mechanisms operate. That understanding has been enhanced by recent insights into the roles of hepcidin and iron regulatory proteins (IRPs) in cellular iron homeostasis within cardiovascular cells. These studies identify intracellular iron deficiency within the cardiovascular tissue as an important contributor to the disease process, and present novel therapeutic strategies based on targeting the machinery of cellular iron homeostasis rather than direct iron supplementation. This review discusses these new insights and their wider implications for the treatment of cardiovascular diseases, focusing on two disease conditions: chronic heart failure and pulmonary arterial hypertension.
缺铁是全球最常见的营养失调症。在心血管疾病患者中普遍存在，且与更差的临床结局相关。铁补充剂的益处已在慢性心力衰竭中得到证实，但关于其在其他心血管疾病中的有效性的数据缺乏或相互矛盾。要认识到铁疗法在心血管疾病中的潜力，需要了解缺铁影响心血管功能的机制，以及这些机制起作用的细胞类型。最近对铁调素和铁调节蛋白（IRP）在心血管细胞内细胞铁稳态中的作用的深入了解，增强了这种认识。这些研究确定心血管组织内的细胞内缺铁是疾病过程的一个重要促成因素，并提出了基于靶向细胞铁稳态机制而非直接补充铁的新型治疗策略。本综述讨论了这些新见解及其对心血管疾病治疗的更广泛影响，重点关注两种疾病情况：慢性心力衰竭和肺动脉高压。
