Iron Dysregulation in Mitochondrial Dysfunction and Alzheimer's Disease.

Antioxidants (Basel, Switzerland). 2022;11(4)
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Alzheimer’s disease (AD) is a progressive deterioration of the brain and memory, for which there is currently no cure. Important to the normal function of the brain is a tightly regulated iron supply and dysregulation in this process may be involved in the development of AD. This review paper aimed to determine how iron dysfunction is related to energy production in the brain and how a type of programmed cell death, that is controlled by iron, may be involved in the development of AD and targeted as a potential treatment. The paper reviewed how iron is regulated, with deficiency sensed by iron regulatory proteins (IRPs), which ultimately results in the release and transport of iron around the body and increased uptake in the diet. If these IRPs become impaired, then a dysregulation of iron levels can occur. Increases in brain iron levels have been associated with progressive development of AD and some areas of the brain are more susceptible than others especially the hippocampus, which is responsible for learning and memory. Increased iron levels in the brain maybe age dependent and associated with cognitive decline in individuals with AD. The mechanisms behind this were discussed and dysregulated iron alongside dysfunctional energy production has been observed in individuals with AD. There is some uncertainty on the causes of this, however it may involve the accumulation of iron which damages lipid membranes around the brain cells, causing them to die in a reaction known as ferroptosis. It was concluded that iron may have a pivotal role in the development of AD due to its importance for energy production and the prevention of brain cell death. This study could be used by healthcare professionals to understand that low iron levels may be involved in the development of AD and that checking and correcting any deficiencies may be of benefit.

Abstract

Alzheimer's disease (AD) is a devastating progressive neurodegenerative disease characterized by neuronal dysfunction, and decreased memory and cognitive function. Iron is critical for neuronal activity, neurotransmitter biosynthesis, and energy homeostasis. Iron accumulation occurs in AD and results in neuronal dysfunction through activation of multifactorial mechanisms. Mitochondria generate energy and iron is a key co-factor required for: (1) ATP production by the electron transport chain, (2) heme protein biosynthesis and (3) iron-sulfur cluster formation. Disruptions in iron homeostasis result in mitochondrial dysfunction and energetic failure. Ferroptosis, a non-apoptotic iron-dependent form of cell death mediated by uncontrolled accumulation of reactive oxygen species and lipid peroxidation, is associated with AD and other neurodegenerative diseases. AD pathogenesis is complex with multiple diverse interacting players including Aβ-plaque formation, phosphorylated tau, and redox stress. Unfortunately, clinical trials in AD based on targeting these canonical hallmarks have been largely unsuccessful. Here, we review evidence linking iron dysregulation to AD and the potential for targeting ferroptosis as a therapeutic intervention for AD.

Lifestyle medicine

Fundamental Clinical Imbalances : Neurological
Patient Centred Factors : Mediators/Iron deficiency
Environmental Inputs : Diet ; Nutrients
Personal Lifestyle Factors : Nutrition
Functional Laboratory Testing : Not applicable
Bioactive Substances : Iron

Methodological quality

Jadad score : Not applicable
Allocation concealment : Not applicable
Publication Type : Journal Article ; Review

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