You are on page 1of 50

| 

 |

 |

  |


m  

     


        

     

      
    

  !  " 
 m    
 m#  
 #   
 $   
 
 

 
=     
  
=ð

h 
 =         
=   

  

==   
  

h 
 
= 
 =   
  
=
     =  




Π   !     


Π    !     

Π % 
    
Π!%   &
'(
$  ) *  
$ 
| 
  
   

 
 


  
  


 
  !


" 
 ! 
h  

      =   


! 

 "      


 =
 
 contain iron in the form of #

Heme: iron inserted in a tetrapyrrole ring



G #

Focus on RBCs:

igure 16-7a, b: Bone marrow


Recommended daily allowance

èàdult male -!$


èàdult female pre menopuasal ʹ $
è àdult female post menopuasal ʹ !$
èGregnant and lactating women ʹ $

|   

 

   
 

 
 

  


 
 

|
 

 
 ? 
ë h
  
    
 

ë r  bioavailability
ë Absorption enhanced by ascorbic acid ,amino acids and
other dietary reducings substances (maintains Fe2+).
ë Inhibited by tanins, phytates (chappatis).
 
ë m 
 
  


ë   bioavailability
 Iron released from complexes by acid, proteases
 Binds to mucin and travels to small bowel.
p ! 

"
 #

p !%
& 

  
 #
á á #'

% #
    ()#
     "

   &

|'(

  

  # 
  

›he basic rule about body iron regulation:

ͻ # 
 
 #'  
* 


ͻ #  



 

 # +  
" #

(     +    % 

 
          
 

 $   ,  #  #     @ 


 # 

| 

#
    (
'
#
 
"
  
p ),-./)-p|0/

| 

"# +

   #  


 
   ('#
# 
# 
 
+ * 

#
#
 
   

| 
 |

 |      


       
         
           
   
 
  
  
 


 
  | 

Œ      


#
$     %&!    

Π     #

Π'   #


 = 

  = 
     (  

  $
  
Œ) 
 =  
  =  (   
   &
  

Œ * +   =  


 
#
     


erric (3+) iron: insoluble at physiological pH

errous (2+) iron:dangerous if free,     


 

0
  


    *
(
 
 


 || 

   



 





|   

 
e2+ e2+ e2+
e-
e3+  
e3+  

Heme Heme





    

Dmt ʹdivalent mteal transporter duodenal cytochrome b1


Import

 a  


ë m ?
 à

?  !
 "! 
 #  
    
   !
 h  $
% 

  $    

  
     
ë  
  
 à
 
 & 
   % 

„xport
 Basolateral Membrane:
ë     (aka Iregr, MTPr)
 Single chain glycoprotein multiple membrane spanning
receptor.
 Present only in mature enterocytes, not crypts. Also liver
Kupffer cells: role in scavenging iron from RBC.
 Via IRP/ IR„ system, upregulated by amount of available
iron.
ë 

 Transmembrane bound ferric oxidase, converting
Fe2+ to Fe+ for loading to Tf.
 Creates a concentration/ electrochemical gradient of
Fe2+ across the basolateral membrane.
 May have transporter function.
| /
    
Πmajor iron transport protein is     
Œ „ach gram of transferrin will bind 1.4 mg
of iron.
Œ ›otal transferrin present in plasma to bind
253-435 mcg of iron/dL of plasma ʹ 



 
%|&
Œ erum iron concentration is 70 ʹ 201
mcg/dL ʹ 95% is complexed with transferrin
Π      
     
   
* #
, - =
        =
. =        =

( !  
Π6emoglobin from degrading RBC is degraded in
liver, spleen ² iron is released.
Œ 85 of this iron is recycled ² delivered to
bone marrow bound to i  
  


     $ #

      % 

  %   $   %  % $# 

           %


%   #   
!   % -   %
  
  
 

?ormal about  %,

›ransferrin saturation under


15 %=
Iron deficiency
›ransferrin uptake

  
  

  


  
  

Cells which need iron express high number of


  
   on their surface
Transferrin - TfR interactions

 „ach TfR can bind two Tf molecules, which are


endocytosed through clathrin coated pits.
 A proton pump generates acidity in the
endosome, facilitating release of Fe from Tf.
 DMT-r transporter exports Fe from endosome.
| 
  
m' 
   
 
Œ  
ë

 



 
     
 (

Π&  
 



Œ   
  )  


    


 iron storage protein
In men, contains up to 1 gram of iron

   # p.|p 0p)0

men: 20-275 ʅg/litre


women: 5-200 ʅg/litre
15 ʅg/litre and less: insufficient iron stores



Πmajor long term storage
form of iron
Œ low release
Œ „stimation of hemosiderin
made on bone marrow tissue
sections
Iron absorption regulation
 Increased
ë aow dietary iron
ë aow body iron stores
ë Increased red cell production
ë aow haemoglobin
ë aow blood oxygen content
 Decreased
ë Systemic inflammation
ë 6igh serum iron and body stored ferritine
Increased Iron Uptake
 aow dietary iron
 Signal from body to ° ii  
 

 ) in response to increased needs


 
aeads to increased activity of:
ë DCytB and DMTr
 Caused by local factors in gut
|  |h|h

 h      


 h 

 

    
 
      
  
h

|  |h|h

 |  
   
       


  |     



  
   
 

 
þh ||h  

|  |h|h


     

 


      

  
  
  

å $ .  
h ||h  
| 
|h|h
 

  
  h
 
  

 
   |
|
| 
|h|h

  

   
    
 
    
       |h 
       
    
  
!      "


   
6 
  



h
| | 
|  |
|
|
|
|
|  |h|h
|

|  
  
| h
  #

   þ$ %



 

    
   
&$ 
h

|  

    

 
    
   
     
 | 

  |
  | 
h 
|

   


     

6" 
      
  
h ||h  |
|

 h