Missense mutations in the
ferroportin gene (SLC11A3) result in
haemochromatosis type 4 [HFE4, Online Mendelian Inheritance in Man (OMIM) reference 606069] or
ferroportin disease, an autosomal dominant disorder characterized by predominantly reticuloendothelial
iron accumulation. To verify whether HFE4 is caused by defective
iron recycling because of loss of functionality of
ferroportin, we down-regulated SLC11A gene expression in human macrophages by using small interfering RNAs (siRNAs). Transfection experiments with
ferroportin siRNAs resulted in a marked reduction (about two-thirds on average) in
ferroportin mRNA levels as detected by quantitative real time polymerase chain reaction. When macrophages were grown in medium supplemented with
iron, cells transfected with siRNAs displayed three- to eightfold increases in staining intensities following Perls reaction. These macrophages also showed significant increases in
H-ferritin content. The observation that
ferroportin mRNA down-regulation to levels compatible with haplo-insufficiency causes increased
iron retention and
H-ferritin synthesis in cultured macrophages has important implications. First, this indicates that
ferroportin levels must be finely regulated in order to maintain cellular
iron homeostasis, and that both copies of SLC11A3 must function efficiently to prevent
iron accumulation. Second, this observation supports the hypothesis that reticuloendothelial
iron overload in patients with
ferroportin disease is caused by loss-of-function mutations in the SLC11A3 gene that mainly impair macrophage
iron recycling.