Iron balance in the cardiac tissue as well as the involvement of the hepcidin-ferroportin (HAMP-FPN) axis in this process and in cardiac functionality are not fully understood. Imbalance of iron occurs in several cardiac diseases, including iron-overload cardiomyopathies such as Friedreich's ataxia (FA). Using induced pluripotent stem cells (iPSCs) to create heart cells (cardiomyocytes) from cells from a FRDA patient and of a healthy control subject in order to study the cardiac iron balance and the HAMP-FPN axis. FA cardiomyocytes maintain the FA-like phenotype. They found that FA cardiomyocytes show an increase in the protein expression of hepcidin and ferroportin. Moreover, they found an unexpected nuclear localization of ferroportin in both affected and unaffected cardiomyocytes. However, the amount of the nuclear ferroportin was lower in FA cardiomyocytes than in controls. These and other data suggest that iron handling and the HAMP-FPN axis regulation in FA cardiac cells are hampered and that ferroportin may have new, still not fully understood, functions.
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