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      Viral Hepatitis and Iron Dysregulation: Molecular Pathways and the Role of Lactoferrin

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          Abstract

          The liver is a frontline immune site specifically designed to check and detect potential pathogens from the bloodstream to maintain a general state of immune hyporesponsiveness. One of the main functions of the liver is the regulation of iron homeostasis. The liver detects changes in systemic iron requirements and can regulate its concentration. Pathological states lead to the dysregulation of iron homeostasis which, in turn, can promote infectious and inflammatory processes. In this context, hepatic viruses deviate hepatocytes’ iron metabolism in order to better replicate. Indeed, some viruses are able to alter the expression of iron-related proteins or exploit host receptors to enter inside host cells. Lactoferrin (Lf), a multifunctional iron-binding glycoprotein belonging to the innate immunity, is endowed with potent antiviral activity, mainly related to its ability to block viral entry into host cells by interacting with viral and/or cell surface receptors. Moreover, Lf can act as an iron scavenger by both direct iron-chelation or the modulation of the main iron-related proteins. In this review, the complex interplay between viral hepatitis, iron homeostasis, and inflammation as well as the role of Lf are outlined.

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          Most cited references127

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          Iron homeostasis in host defence and inflammation.

          Iron is an essential trace element for multicellular organisms and nearly all microorganisms. Although iron is abundant in the environment, common forms of iron are minimally soluble and therefore poorly accessible to biological organisms. Microorganisms entering a mammalian host face multiple mechanisms that further restrict their ability to obtain iron and thereby limit their pathogenicity. Iron levels also modulate host defence, as iron content in macrophages regulates their cytokine production. Here, we review recent advances that highlight the role of systemic and cellular iron-regulating mechanisms in protecting hosts from infection, emphasizing aspects that are applicable to human health and disease.
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            Interleukin-6 induces hepcidin expression through STAT3.

            Iron homeostasis is maintained through meticulous regulation of circulating hepcidin levels. Hepcidin levels that are inappropriately low or high result in iron overload or iron deficiency, respectively. Although hypoxia, erythroid demand, iron, and inflammation are all known to influence hepcidin expression, the mechanisms responsible are not well defined. In this report we show that the inflammatory cytokine interleukin-6 (IL-6) directly regulates hepcidin through induction and subsequent promoter binding of signal transducer and activator of transcription 3 (STAT3). STAT3 is necessary and sufficient for the IL-6 responsiveness of the hepcidin promoter. Our findings provide a mechanism by which hepcidin can be regulated by inflammation or, in the absence of inflammatory stimuli, by alternative mechanisms leading to STAT3 activation.
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              LEAP-1, a novel highly disulfide-bonded human peptide, exhibits antimicrobial activity.

              We report the isolation and characterization of a novel human peptide with antimicrobial activity, termed LEAP-1 (liver-expressed antimicrobial peptide). Using a mass spectrometric assay detecting cysteine-rich peptides, a 25-residue peptide containing four disulfide bonds was identified in human blood ultrafiltrate. LEAP-1 expression was predominantly detected in the liver, and, to a much lower extent, in the heart. In radial diffusion assays, Gram-positive Bacillus megaterium, Bacillus subtilis, Micrococcus luteus, Staphylococcus carnosus, and Gram-negative Neisseria cinerea as well as the yeast Saccharomyces cerevisiae dose-dependently exhibited sensitivity upon treatment with synthetic LEAP-1. The discovery of LEAP-1 extends the known families of mammalian peptides with antimicrobial activity by its novel disulfide motif and distinct expression pattern.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Molecules
                Molecules
                molecules
                Molecules
                MDPI
                1420-3049
                24 April 2020
                April 2020
                : 25
                : 8
                : 1997
                Affiliations
                [1 ]Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, 00185 Rome, Italy; antonio.franchitto@ 123456uniroma1.it (A.F.); paolo.onori@ 123456uniroma1.it (P.O.); eugenio.gaudio@ 123456uniroma1.it (E.G.)
                [2 ]Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; luigi.rosa@ 123456uniroma1.it (L.R.); mariastefania.lepanto@ 123456uniroma1.it (M.S.L.); piera.valenti@ 123456uniroma1.it (P.V.)
                [3 ]Department of Biosciences and Territory, University of Molise, 86090 Pesche, Italy; antimo.cutone@ 123456unimol.it
                [4 ]Eleonora Lorillard Spencer Cenci Foundation, 00185 Rome, Italy
                Author notes
                [* ]Correspondence: romina.mancinelli@ 123456uniroma1.it ; Tel.: +39-06-49918063
                [†]

                These authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0003-2040-0581
                https://orcid.org/0000-0002-1252-6080
                https://orcid.org/0000-0002-7492-8616
                Article
                molecules-25-01997
                10.3390/molecules25081997
                7221917
                32344579
                c078e964-f1b1-45c5-a535-11653c6537e8
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 25 March 2020
                : 23 April 2020
                Categories
                Review

                liver,viral infections,hepatitis,iron,iron homeostasis,iron proteins,lactoferrin,lactoferrin receptors,hepcidin,ferroportin

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