Hereditary hyperferritinemia-cataract syndrome (HHCS) is a novel genetic disorder characterized by elevated serum ferritin and early onset cataract formation. The excessive ferritin production in HHCS patients arises from aberrant regulation of L-ferritin translation caused by mutations within the ironresponsive element (IRE) of the L-ferritin transcript. IREs serve as binding sites for iron regulatory proteins (IRPs), iron-sensing proteins that regulate ferritin translation. Previous observations suggested that each unique HHCS mutation conferred a characteristic degree of hyperferritinemia and cataract severity in affected individuals. Here we have measured the in vitro affinity of the IRPs for the mutant IREs and correlated decreases in binding affinity with clinical severity. Thermodynamic analysis of these IREs has also revealed that although some HHCS mutations lead to changes in the stability and secondary structure of the IRE, others appear to disrupt IRP-IRE recognition with minimal effect on IRE stability. HHCS is a noteworthy example of a human genetic disorder that arises from mutations within a protein-binding site of an mRNA cis-acting element. Analysis of the effects of these mutations on the energetics of the RNA-protein interaction explains the phenotypic variabilities of the disease state.
Several reports have described a new autosomal dominant disorder called hereditary hyperferritinemia-cataract syndrome (HHCS)1 (1-12). This condition is characterized by a combination of elevated levels of serum ferritin and congenital nuclear cataract. Human ferritin is composed of two different types of subunit (H-ferritin and L-ferritin), although the relative proportion of each subunit in the ferritin copolymer varies among tissues (13). Through the use of monoclonal antibodies specific for either H-or L-ferritin, the excess serum ferritin in HHCS patients has been shown to be predominantly L-ferritin (3, 7). A close relationship has also been established between monocyte L-ferritin content and serum ferritin concentration (7), suggesting that the excess production of L-ferritin in cells is directly responsible for the hyperferritinemia. Although serum ferritin is thought to reflect body iron stores, individuals with HHCS do not appear to suffer from iron overload (1, 2).The expression of both H-ferritin and L-ferritin is normally regulated according to intracellular iron concentration by means of iron-responsive elements (IREs) that are found within the 5Ј-untranslated regions of their transcripts (14, 15). These regulatory elements interact with the iron regulatory proteins IRP1 and IRP2, which are both capable of sensing cellular iron status. Under conditions of intracellular iron depletion, both IRP1 and IRP2 bind to IREs with high affinity.
The binding of an IRP to the ferritin IRE prevents the binding of the 43 S translation initiation complex to the transcript (16, 17) and thus blocks translation of the ferritin protein. When intracellular iron concentrations rise, IRP1 acquires a [4Fe-4S] cluster ...