Reply: Iron chelation may harm patients with COVID-19

Abobaker, Anis

doi:10.1007/s00228-020-02988-9

Cited by 13 publications

(10 citation statements)

References 8 publications

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“…Aconitase is an iron-dependent coronavirus replication protein, whose function was blocked by the use of iron chelators. These findings suggest the iron dependency of coronaviruses [80][81][82].…”

Section: Iron Rna Viruses and The Rna World Hypothesismentioning

confidence: 73%

“…TPE may prove beneficial in the setting of COVID-19 as evidenced by COVID-19 patients who recovered and were discharged after undergoing TPE therapy [101]. Iron chelators may play an additional role here as well, by decreasing the degradation of ferritin by lysosomes, decreasing the production of free radicals, and promoting the downregulation of hepcidin [82].…”

Section: Insights From Hyperferritinemiamentioning

confidence: 99%

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Low iron mitigates viral survival: insights from evolution, genetics, and pandemics—a review of current hypothesis

Menshawey

Alserr

et al. 2020

Egypt J Med Hum Genet

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Background Upon re-examination of our human history, evolutionary perspectives, and genetics, a prevailing iron deficiency phenotype appears to have evolved to protect the human race from extinction. Body In this review, we summarize the evolutionary and genetic perspectives pointing towards the hypothesis that low iron mitigates infection. The presence of infection promotes the generation of resistance alleles, and there are some evolutionary and genetic clues that suggest the presence of an iron deficiency phenotype that may have developed to protect against infection. Examples include the relative paucity of iron overload genes given the essential role of iron, as well as the persistence of iron deficiency among populations in spite of public health efforts to treat it. Additional examination of geographic areas with severe iron deficiency in the setting of pandemics including H1N1, SARS, and COVID-19 reveals that areas with higher prevalence of iron deficiency are less affected. RNA viruses have several evolutionary adaptations which suggest their absolute need for iron, and this dependency may be exploited during treatment. Conclusion RNA viruses pose a unique challenge to modern healthcare, with an average of 2–3 new pathogens being discovered yearly. Their overarching requirements for iron, along with human evolutionary and genetic adaptations which favored an iron deficiency phenotype, ultimately suggest the potential need for iron control in these infections.

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Section: Iron Rna Viruses and The Rna World Hypothesismentioning

confidence: 73%

Section: Insights From Hyperferritinemiamentioning

confidence: 99%

Low iron mitigates viral survival: insights from evolution, genetics, and pandemics—a review of current hypothesis

Menshawey

Alserr

et al. 2020

Egypt J Med Hum Genet

View full text Add to dashboard Cite

show abstract

“…Systemic inflammations are generally associated with increased serum ferritin levels: indeed, during strong inflammation state, cytokines stimulate ferritin and the hepcidin synthesis, the main regulator of the tissue iron store [ 32 ]. Regarding this, a high level of ferritin has been reported in patients with COVID-19 disease [ 33 , 34 , 35 ]: on one hand, SARS-CoV-2 attacks one of the beta chains of the hemoglobin, which leads to the dissociation of iron from heme and the consequent increased free iron and ferritin levels in the body [ 11 , 34 , 36 , 37 , 38 ]; on the other hand, one of the causes has been associated with the inflammation induced by COVID-19 infection, with a remarkable overexpression of IL-6, IL-1β, and IFN-γ, leading to the increase of the hepcidin level [ 6 , 39 , 40 ]. Hepcidin, as key iron regulatory hormone, sequesters iron in the enterocytes and macrophages, enhancing intracellular levels of ferritin and preventing iron efflux from store cells through the inhibition of the iron-exporting protein ferroportin [ 41 ].…”

Section: Iron and Sars-cov-2mentioning

confidence: 99%

Role of Iron Chelation and Protease Inhibition of Natural Products on COVID-19 Infection

Carota

Ronsisvalle

Panarello

et al. 2021

JCM

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Although the epidemic caused by SARS-CoV-2 callings for international attention to develop new effective therapeutics, no specific protocol is yet available, leaving patients to rely on general and supportive therapies. A range of respiratory diseases, including pulmonary fibrosis, have been associated with higher iron levels that may promote the course of viral infection. Recent studies have demonstrated that some natural components could act as the first barrier against viral injury by affecting iron metabolism. Moreover, a few recent studies have proposed the combination of protease inhibitors for therapeutic use against SARS-CoV-2 infection, highlighting the role of viral protease in virus infectivity. In this regard, this review focuses on the analysis, through literature and docking studies, of a number of natural products able to counteract SARS-CoV-2 infection, acting both as iron chelators and protease inhibitors.

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“…Could, for instance, clinical evidence be gathered to clarify if disorders of iron homeostasis might exacerbate symptoms in COVID-19 patients? As a final note, given the many known and yetto-be-discovered intricacies of iron homeostasis in the body, research on therapeutic strategies that, for example, propose to utilize iron chelation or hepcidin antagonists should proceed cautiously [1,52].…”

Section: Hepcidin Iron Biology and Diagnosticsmentioning

confidence: 99%

COVID-19 and iron dysregulation: distant sequence similarity between hepcidin and the novel coronavirus spike glycoprotein

Ehsani

2020

Biol Direct

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The spike glycoprotein of the SARS-CoV-2 virus, which causes COVID-19, has attracted attention for its vaccine potential and binding capacity to host cell surface receptors. Much of this research focus has centered on the ectodomain of the spike protein. The ectodomain is anchored to a transmembrane region, followed by a cytoplasmic tail. Here we report a distant sequence similarity between the cysteine-rich cytoplasmic tail of the coronavirus spike protein and the hepcidin protein that is found in humans and other vertebrates. Hepcidin is thought to be the key regulator of iron metabolism in humans through its inhibition of the iron-exporting protein ferroportin. An implication of this preliminary observation is to suggest a potential route of investigation in the coronavirus research field making use of an already-established literature on the interplay of local and systemic iron regulation, cytokine-mediated inflammatory processes, respiratory infections and the hepcidin protein. The question of possible homology and an evolutionary connection between the viral spike protein and hepcidin is not assessed in this report, but some scenarios for its study are discussed.

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Reply: Iron chelation may harm patients with COVID-19

Cited by 13 publications

References 8 publications

Low iron mitigates viral survival: insights from evolution, genetics, and pandemics—a review of current hypothesis

Low iron mitigates viral survival: insights from evolution, genetics, and pandemics—a review of current hypothesis

Role of Iron Chelation and Protease Inhibition of Natural Products on COVID-19 Infection

COVID-19 and iron dysregulation: distant sequence similarity between hepcidin and the novel coronavirus spike glycoprotein

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