# Dissection and Manipulation of the Cellular Response to Iron Restriction

> **NIH NIH R01** · UNIVERSITY OF VIRGINIA · 2020 · $546,864

## Abstract

Project Summary/Abstract
The erythroid iron restriction response underlies two of the most common types of anemia: anemia of chronic
disease and inflammation (ACDI) and iron deficiency anemia (IDA). These anemias confer a major global
burden of morbidity and mortality, with no optimal therapies yet available for ACDI. This lineage-specific
progenitor response to nutrient deprivation involves loss of isocitrate production and can be reversed by
providing exogenous isocitrate in vitro and in vivo. We have recently developed an oral formulation showing
sustained efficacy in murine ACDI using a clinically feasible dosing regimen. Results from the last funding
period identified the molecular basis for erythropoietin (Epo) resistance associated with iron restriction, a major
clinical problem (J. Exp. Med. 2018). In essence, iron deprivation caused a failure in cell surface delivery of
the Epo receptor (EpoR) and associated factors (Scrib and TfR2). This abnormality was reversed by isocitrate
treatment which restored Epo responsiveness. More recently, we have discovered that iron and isocitrate
modulate Golgi integrity in an erythroid lineage-specific manner. Furthermore, erythroid iron restriction induced
an early and sustained disruption of the microtubule cytoskeleton, a structure known to be critical for Golgi
maintenance. Isocitrate treatment did not prevent the initial microtubule disruption but promoted its
reassembly at later time points. Our studies of patient specimens, as well as prior published reports, support
the clinical relevance of this microtubule response. We then mined a comprehensive proteomic dataset on
staged human erythroid progenitors to identify features that might contribute to the microtubule instability. At
all stages, erythroid cells manifested a striking deficiency of stabilizing microtubule-associated proteins
(MAPs), such as the ubiquitous MAP4, and abundantly expressed the microtubule destabilizer, Stathmin 1
(STMN1). We therefore postulated the existence of a non-canonical, iron-regulated, stabilizing MAP and
examined ferritin heavy chain (FTH1), known to possess microtubule bundling activity and be controlled by
iron. Erythroid iron restriction caused a prompt and potent FTH1 decline due to proteolytic and non-proteolytic
mechanisms, the latter likely involving IRP translational repression. Isocitrate rescued FTH1 levels but did not
prevent early proteolysis; a likely target in its rescue is IRP1, known to be regulated by isocitrate and to
participate in the erythroid iron restriction response. Importantly, lentiviral knockdown of FTH1 disrupted
microtubules and impaired differentiation in a manner similar to iron restriction. Vesicular and protein transport
may occur through either microtubule-dependent or –independent mechanisms. Notably, we discovered a
strong and specific interaction of endogenous FTH1 with EpoR in erythroid cells, implicating FTH1 in
microtubule recruitment of receptor vesicles. The proposed expe...

## Key facts

- **NIH application ID:** 10013228
- **Project number:** 5R01DK079924-10
- **Recipient organization:** UNIVERSITY OF VIRGINIA
- **Principal Investigator:** Adam N. Goldfarb
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $546,864
- **Award type:** 5
- **Project period:** 2008-02-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10013228

## Citation

> US National Institutes of Health, RePORTER application 10013228, Dissection and Manipulation of the Cellular Response to Iron Restriction (5R01DK079924-10). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10013228. Licensed CC0.

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