In Vivo Silencing of Intestinal DMT1 Mitigates Iron Loading in β-thalassemia Intermedia (Hbbth3/+) Mice

Abstract

β-thalassemia is an iron-loading anemia caused by homozygous mutations in the hemoglobin subunit beta gene. In β-thalassemia major, frequent blood transfusions and elevated absorption of dietary iron can lead to iron overload, which exacerbates pathological outcomes. Iron absorption is inappropriately high due to blunted expression of the iron-regulatory hormone hepcidin. Low hepcidin potentiates iron export from duodenal enterocytes by ferroportin (FPN); cellular iron depletion then secondarily increases expression of the iron importer, divalent metal-ion transporter 1 (DMT1). High expression of both transporters drives excessive iron absorption and ultimately, iron overload. In non-transfusion-dependent, β-thalassemia intermedia (βTI), hepcidin suppression and high iron absorption are the sole causes of iron loading. In this investigation, two parallel hypotheses were tested in βTI ( Hbbth3/+) mice: 1) Intestinal DMT1 drives elevated iron absorption and precipitates iron overload; and 2) In vivo silencing of intestinal DMT1 mitigates iron loading. Initial experiments revealed that intestine-specific ablation of DMT1 caused a pathophysiological shift from iron overload to an iron-deficiency phenotype with exacerbated anemia, thus proving that intestinal DMT1 is required for iron absorption in Hbbth3/+ mice. Subsequent studies utilized folic acid-coupled, ginger nanoparticle-derived lipid vectors to deliver functional DMT1 siRNAs to the duodenal epithelium of 4-week-old Hbbth3/+ mice daily for 16 days to assess the impact on iron loading. Knockdown of intestinal DMT1 blunted iron loading in Hbbth3/+ mice, thus supporting hypothesis 2. These notable experimental outcomes establish intestinal DMT1 as a plausible therapeutic target to mitigate iron overload in βTI and possibly other non-transfusion dependent, iron-loading anemias. This work was supported by grants R01 DK074867 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and R01 DK109717 from NIDDK and the Offce of Dietary Supplements (to JFC). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.