Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Starchl, C.
Iron – risk or benefit? The role of imbalance in iron homeostasis in the pathogenesis of cardiovascular diseases and therapeutic options for iron overload and deficiency.
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2020. pp. 86
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- Autor*innen der Med Uni Graz:
- Geiger Christina
- Betreuer*innen:
- Amrein Karin
- Graier Wolfgang
- Altmetrics:
- Abstract:
- The maintenance of the iron homeostasis is essential for several physiological processes and is mainly controlled by the systemic hepcidin and ferroportin axis, as well as intracellular regulatory proteins. It has been proven that heart disease is a common consequence of iron metabolism disorders, including both iron deficiency and iron overload. More than half of the patients with chronic heart failure suffer from iron deficiency, which - as a severe co-morbidity - can exacerbate symptoms and contribute to a poor prognosis. Studies show that myocardial iron deficiency is not only caused by defective iron absorption or decreased systemic iron levels, but rather by intrinsic myocardial iron deregulation, including altered expression of hepcidin in the failing heart. On the contrary, iron overload can result from disordered gut absorption or frequent blood transfusions and is mainly observed in patients with genetic diseases like beta-thalassemia major or hemochromatosis. The latter is the most widely spread genetic disease in Northern and Central Europe, considering ~15% of the population are heterocygotic carriers. Iron can cause oxidative damage provoking a considerable number of diseases, including atherosclerosis by lipid peroxidation. Moreover, macrophages are important players in iron metabolism: They are not only part of the body iron deposit, but also play an important role in the onset, progression and destabilization of atherosclerotic plaques. The aim of this thesis is to provide an overview of the iron metabolism, the causes behind iron disorders like iron deficiency and overload, as well as the mechanisms leading to atherosclerosis, cardiomyopathy and heart failure associated with imbalance of iron homeostasis. The final part of this thesis will discuss current treatment options for iron deficiency involving oral or intravenous supplementation and for iron overload phlebotomy or chelators from a clinical perspective.