Iron metabolism and atherosclerosis

• Published in: Trends in endocrinology and metabolism 2023-07, Vol.34 (7), p.404-413
• Main Authors: Guo, Qian, Qian, Christopher, Qian, Zhong-Ming
• Format: Article
• Language: English
• Subjects: Animals; ApoE deficiency; arterial wall; Atherosclerosis; Hemochromatosis - genetics; Hemochromatosis - metabolism; Homeostasis; iron; Iron - metabolism; mice
• ISSN: 1043-2760; 1879-3061
• DOI: 10.1016/j.tem.2023.04.003

The fact that hereditary hemochromatosis (HH) patients do not show any increased incidence of atherosclerosis is often cited as the most convincing evidence against the role of iron in atherosclerosis.The key question about whether atherosclerosis occurs is whether there is excess iron accumulation in the artery wall, the actual location of atherosclerosis.An increase in atherosclerosis should not be observed in HH because the iron homeostasis of the arterial wall in HH is not affected.Iron content in the aortic tissue was not significantly affected in those animal studies that reported the conflicting results against iron’s role in atherogenesis.The reviewed findings, discussion, and analysis strongly suggest a causal link between iron and atherosclerosis. Despite several decades of study, whether iron is involved in the development of atherosclerosis remains a controversial and unresolved issue. Here, we focus on the up-to-date advances in studies on role of iron in atherosclerosis and discuss possible reasons why patients with hereditary hemochromatosis (HH) do not show any increased incidence of atherosclerosis. In addition, we analyze conflicting results concerning the role of iron in atherogenesis from several epidemiological and animal studies. We argue that atherosclerosis is not observed in HH because iron homeostasis in the arterial wall, the actual location of atherosclerosis, is not significantly affected, and support a causal link between iron in the arterial wall and atherosclerosis.