Cao Kangna, Fan Xiaoqing, Wong Raymond S M, Yan Xiaoyu
Guangdong-Hong Kong-Macao Joint Laboratory for New Drug Screening, School of Pharmacy, The Chinese University of Hong Kong, Hong Kong SAR, P. R. China.
Division of Hematology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, P. R. China.
ACS Pharmacol Transl Sci. 2025 May 30;8(6):1711-1725. doi: 10.1021/acsptsci.5c00097. eCollection 2025 Jun 13.
Iron replenishment is a cornerstone therapy for anemia in diverse diseases. While its role in erythrocyte hemoglobinization is well-established, the broader impact of iron on other aspects of hematopoiesis, such as thrombopoiesis, remains poorly understood. In this study, we demonstrate that iron plays a regulatory role in the commitment of hematopoietic stem and progenitor cells (HSPCs) toward erythroid and megakaryocytic lineages. Using colony-forming unit assays and flow cytometry, we observed that iron increases the proportion of erythroid cells while reducing the proportion of megakaryocytic cells. Transcriptomic profiling and functional output analyses identified the MAPK/ERK pathway as a critical mediator of iron-regulated HSPCs' commitment. Corroborating findings, rats with iron deficiency anemia exhibited continuously elevated platelets and decreased red blood cell counts, while intravenous iron supplementation reversed these effects. This effect of iron was enhanced in combination with erythropoietin, a key cytokine in erythropoiesis. A mechanism-based pharmacokinetic/pharmacodynamic model was developed to quantify the impact of iron on the two lineages. The dynamic interplay between iron levels and the development of erythropoiesis and thrombopoiesis was accurately recapitulated in rats. The model was further extrapolated to humans and validated with clinical data. Overall, this work not only provides functional insights into the pivotal role of iron in erythropoiesis and thrombopoiesis but also holds translational implications for optimizing iron therapy in anemia and potentially other hematologic conditions where erythropoiesis and thrombopoiesis are affected.
铁补充疗法是治疗多种疾病所致贫血的基石疗法。虽然铁在红细胞血红蛋白化过程中的作用已得到充分证实,但其对造血其他方面(如血小板生成)的更广泛影响仍知之甚少。在本研究中,我们证明铁在造血干细胞和祖细胞(HSPCs)向红系和巨核系分化过程中发挥调节作用。通过集落形成单位测定和流式细胞术,我们观察到铁增加了红系细胞的比例,同时降低了巨核系细胞的比例。转录组分析和功能输出分析确定丝裂原活化蛋白激酶/细胞外信号调节激酶(MAPK/ERK)信号通路是铁调节HSPCs分化的关键介质。进一步的研究发现,缺铁性贫血大鼠的血小板持续升高,红细胞计数降低,而静脉补铁可逆转这些效应。铁与促红细胞生成素(红细胞生成的关键细胞因子)联合使用时,这种效应增强。我们建立了一个基于机制的药代动力学/药效学模型,以量化铁对这两个谱系的影响。铁水平与红细胞生成和血小板生成之间的动态相互作用在大鼠中得到了准确再现。该模型进一步外推至人类,并通过临床数据进行了验证。总体而言,这项工作不仅为铁在红细胞生成和血小板生成中的关键作用提供了功能见解,也为优化贫血及其他可能影响红细胞生成和血小板生成的血液系统疾病的铁治疗具有转化意义。