HomeCirculation: Cardiovascular GeneticsVol. 3, No. 2Response to Letter by Ryan et al Regarding Article, “Do Hemochromatosis Mutations Protect Against Iron-Mediated Atherogenesis?” Free AccessResearch ArticlePDF/EPUBAboutView PDFSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessResearch ArticlePDF/EPUBResponse to Letter by Ryan et al Regarding Article, “Do Hemochromatosis Mutations Protect Against Iron-Mediated Atherogenesis?” Jerome L. Sullivan Jerome L. SullivanJerome L. Sullivan Burnett School of Biomedical Sciences, University of Central Florida College of Medicine, Orlando, Fla Search for more papers by this author Originally published1 Apr 2010https://doi.org/10.1161/CIRCGENETICS.110.945212Circulation: Cardiovascular Genetics. 2010;3:e4Ryan et al1 propose another factor that may protect patients with hemochromatosis from atherosclerosis, namely, suppression of monocyte chemoattractant protein-1 (MCP-1). To know how much of the antiatherogenic effects of hemochromatosis mutations is due to this suppression will require additional investigation. Lawless et al2 report that MCP-1 is low with the C282Y variant but increased with H63D. This appears consistent with the hypothesis, because some H63D cases have higher hepcidin expression.3–5 In H63D, hepcidin normalized against ferritin is low, but the higher absolute hepcidin concentrations may allow higher macrophage iron in this variant. As noted in my study,6 there is a variable impact of genotype on hepcidin expression. Genotype of subjects in a study to test the hypothesis would need to be determined; however, testing the hypothesis would not rely directly on showing an association of genotype with disease. The hypothesis implies that protection against atherogenesis is inversely proportional to hepcidin expression. In an epidemiological study, the hypothesis suggests that among those with any 1 of the number of iron-overloading genotypes, protection against atherogenesis would be seen as a function of the degree of life-long hepcidin downregulation.In mice, the effects of Hfe−/− on atherogenesis on an ApoE−/− background may be informative on the question of the effects of Hfe loss and any changes in MCP-1 on atherogenesis. Loss of Hfe in mice increases their survival after infection with Salmonella typhimurium.7,8 Altered macrophage function associated with mutationally low macrophage iron may also lessen atherogenesis in Hfe−/−ApoE−/− double-knockout animals (nutritional iron depletion, sufficient to lessen macrophage iron, diminishes atherosclerosis in the ApoE−/− knockout mouse9). In Hfe knockouts, resting macrophages express MCP-1, and infection with S typhimurium increases macrophage MCP-1.7Hfe−/− mice are protected from S typhimurium despite the expression of MCP-1. Further study will be required to determine whether these animals exhibit some protection against atherosclerosis as well.DisclosuresNone. References 1 Ryan JD, Ryan E, Lawless M, Stolte J, Muckenthaler MU, Crowe J. Hepatic MCP-1 gene expression is suppressed in iron-loaded male C282Y homozygotes and correlates with hepcidin expression. Poster session presented at: International BioIron Society 2009 Meeting; June 7–11, 2009; Porto, Portugal. Am J Hematol. 2009; 84: E236–E375.CrossrefGoogle Scholar2 Lawless MW, White M, Mankan AK, Dwyer MJ, Norris S. Elevated MCP-1 serum levels are associated with the H63D mutation and not the C282Y mutation in hereditary hemochromatosis. Tissue Antigens. 2007; 70: 294–300.CrossrefMedlineGoogle Scholar3 Piperno A, Girelli D, Nemeth E, Trombini P, Bozzini C, Poggiali E, Phung Y, Ganz T, Camaschella C. Blunted hepcidin response to oral iron challenge in HFE-related hemochromatosis. Blood. 2007; 110: 4096–4100.CrossrefMedlineGoogle Scholar4 Bozzini C, Campostrini N, Trombini P, Nemeth E, Castagna A, Tenuti I, Corrocher R, Camaschella C, Ganz T, Olivieri O, Piperno A, Girelli D. Measurement of urinary hepcidin levels by SELDI-TOF-MS in HFE-hemochromatosis. Blood Cells Mol Dis. 2008; 40: 347–352.CrossrefMedlineGoogle Scholar5 Mast AE, Foster TM, Pinder HL, Beczkiewicz CA, Bellissimo DB, Murphy AT, Kovacevic S, Wroblewski VJ, Witcher DR. Behavioral, biochemical, and genetic analysis of iron metabolism in high-intensity blood donors. Transfusion. 2008; 48: 2197–2204.CrossrefMedlineGoogle Scholar6 Sullivan JL. Do hemochromatosis mutations protect against iron-mediated atherogenesis? Circ Cardiovasc Genet. 2009; 2: 652–657.LinkGoogle Scholar7 Nairz M, Theurl I, Schroll A, Theurl M, Fritsche G, Lindner E, Seifert M, Crouch ML, Hantke K, Akira S, Fang FC, Weiss G. Absence of functional Hfe protects mice from invasive Salmonella enterica serovar typhimurium infection via induction of lipocalin-2. Blood. 2009; 114: 3642–3651.CrossrefMedlineGoogle Scholar8 Wang L, Johnson EE, Shi HN, Walker WA, Wessling-Resnick M, Cherayil BJ. Attenuated inflammatory responses in hemochromatosis reveal a role for iron in the regulation of macrophage cytokine translation. J Immunol. 2008; 181: 2723–2731.CrossrefMedlineGoogle Scholar9 Lee TS, Shiao MS, Pan CC, Chau LY. Iron-deficient diet reduces atherosclerotic lesions in apoE-deficient mice. Circulation. 1999; 99: 1222–1229.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetails April 2010Vol 3, Issue 2 Advertisement Article InformationMetrics https://doi.org/10.1161/CIRCGENETICS.110.945212 Originally publishedApril 1, 2010 PDF download Advertisement SubjectsEpidemiologyGene Expression and RegulationGenetically Altered and Transgenic ModelsGeneticsGrowth Factors/CytokinesPathophysiology
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