Hyperferritinaemia: An Iron Sword of Autoimmunity

Abstract

Background:: Ferritin is a molecule that plays many roles being the storage for iron, signalling molecule, and modulator of the immune response. Methods:: Different electronic databases were searched in a non-systematic way to find out the literature of interest. Results:: The level of ferritin rises in many inflammatory conditions including autoimmune disorders. However, in four inflammatory diseases (i.e., adult-onset Still’s diseases, macrophage activation syndrome, catastrophic antiphospholipid syndrome, and sepsis), high levels of ferritin are observed suggesting it as a remarkable biomarker and pathological involvement in these diseases. Acting as an acute phase reactant, ferritin is also involved in the cytokine-associated modulator of the immune response as well as a regulator of cytokine synthesis and release which are responsible for the inflammatory storm. Conclusion:: This review article presents updated information on the role of ferritin in inflammatory and autoimmune diseases with an emphasis on hyperferritinaemic syndrome.

Host Genetics at the Intersection of Autoimmunity and COVID-19: A Potential Key for Heterogeneous COVID-19 Severity

“…Interestingly, secondary HLH can be seen in rheumatological diseases, such as systemic lupus erythematosus (SLE), juvenile idiopathic arthritis, and rheumatoid arthritis (RA), which are all autoimmune conditions ( 53 ). Besides HLH, hyperferritinemia is a finding in a number of ADs such as adult-onset Still’s disease, and catastrophic APS ( 54 ). As per the observed link between autoimmunity and COVID-19, drugs commonly used in AD, such as corticosteroids, and IL-6R and IL-1 antagonists, are being tested and used in COVID-19 cases ( 55 , 56 ).…”

Poor Prognostic Biochemical Markers Predicting Fatalities Caused by COVID-19: A Retrospective Observational Study From a Developing Country

“…Microscopically, ferritin plays a defensive role within the body by limiting the supply of iron, due to which elevated serum ferritin levels can be seen in individuals with high pathogenic loads [4]. Ferritin not only limits the availability of iron to the pathogen but also regulates cytokine synthesis and release that are responsible for the cytokine (proinflammatory) storm [5]. C-reactive protein (CRP) is an acute-phase reactant that is synthesized by the liver in response to inflammation or infection.…”

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“…Ferritin tends to reduce the iron supply as a part of a defense mechanism, hence incase of high pathogenic load elevated levels of ferritin are observed [39]. Along with the reduction in iron supply, ferritin also tends to regulate [40] Another acute phase reactant synthesized in response to infection or inflammation is C-reactive protein (CRP). CRP is synthesized by the liver.…”