Abstract
Importance of the field: Iron is an essential metal required for biochemical processes in the body including hemoglobin synthesis and cellular proliferation. However, unbound or excess iron can be toxic as a catalyst for free radical reactions, damaging cellular membranes, proteins and DNA by means of reactive oxygen species. There is no active mechanism to excrete this metal, and it must be highly regulated to avoid cytotoxic harm. The liver is the major storage organ for iron and produces transferrin and hepcidin, which help to regulate iron. Iron homeostasis is ultimately controlled at the level of absorption in the duodenum. In the last 13 years, the discoveries of hepcidin and the HFE gene have propelled our understanding of iron metabolism and iron overload disorders.
Areas covered in this review: This review includes findings from many landmark studies over the course of 80 years, but with particular emphasis on recently established evidence. Iron homeostasis, hepcidin, common iron studies, liver biopsy and iron overload diseases are some of the subject matter.
What the reader will gain: Readers will gain an up-to-date understanding about iron metabolism, as well as the usefulness of iron tests and an overview of HFE-related and non-HFE-related hemochromatosis.
Take home message: It is important for the scientist and clinician alike to understand iron metabolism in order to perceive appropriate diagnostic testing and treatment.
Notes
The box summarises key points contained in the article.