Main Article Content
SARS-CoV-2, Iron homeostasis, hepcidin, ferritin
Clinical observations in concert with literary data demonstrate that detrimental complications of COVID19-induced pathology (acute respiratory distress syndrome, multi-organ failure, Kawasaki-like disease etc.), could result from a disturbance of local iron homeostasis (FeH) in damaged tissues followed by abnormal coagulation in small vessels. To resolve these complications the local FeH needs to be recovered. Hepcidin, as a master regulator of FeH is both a major player in the recovery and a marker of an efficacy of the restoration. Therefore, both local and systemic hepcidin levels could serve as a dynamic marker of disease progression (the more hepcidin the worse is disease) and treatment efficacy (after iron homeostasis is recovered hepcidin disappears). On the contrast, artificial attempts to suppress hepcidin expression directly or application of hepcidin antagonists could be detrimental. Overall, more comprehensive research of hepcidin role in COVID-19 pathology is needed.
2. Sukhomlin T. Fibrinolysis Shutdown in COVID-19-Infected Patients Can Result from Iron-Induced Stabilization of Fibril Clots. J Am Coll Surg. 2020;S1072-7515(20)31499-X. doi: 10.1016/j.jamcollsurg.2020.08.170. Epub ahead of print.
3. Hadadi A, Mortezazadeh M, Kolahdouzan K, Alavian G. Does recombinant human Erythropoietin administration in critically ill COVID-19 patients have miraculous therapeutic effects? J Med Virol. 2020;92(7):915-918.
4. Sukhomlin T. Could an acute respiratory distress syndrome in COVID-19 infected patients be calmed down simply by iron withdrawal from lung tissues? J Med Virol. 2020; doi: 10.1002/jmv.26372. Epub ahead of print.
5. Coffey R, Ganz T. Iron homeostasis: An anthropocentric perspective. J Biol Chem. 2017;292(31):12727-12734. doi: 10.1074/jbc.R117.781823.
6. Pretorius E, Vermeulen N, Bester J, Lipinski B, Kell DB. A novel method for assessing the role of iron and its functional chelation in fibrin fibril formation: the use of scanning electron microscopy. Toxicol Mech Methods. 2013;23(5):352-9.