Is Ferritin one of The Missing Link in Putting Together the Pieces of Covid 19 and Mucormycosis?

  • sarah bharati vidyapeeth deemed to be university
Keywords: ferritin, covid-19, mucormycosis

Abstract

Abstract

The exact cause of increased incidence of mucormycosis in covid-19 patient is an enigma. Cause cannot be attributed to a single factor, although many theories are doing the rounds. Predisposing factors include an immune-compromised host (both due to viral infectionas well as systemic corticosteroid therapy), diabetic ketoacidosis, zinc medications etc.Medical professionals are at a loss of words in explaining the exact cause of this phenomenon. The purpose of this review is to hypothesise if increased availability of iron in the host has any adjunctive role in increased incidence of mucormycosis in covid-19 patients.

Recent findings- Hyperferritenemia has been detected in covid-19 patients with increase levels in tune with high morbidity, mortality and severity of covid 19. Dual role has been attributed to this iron containing protein actingboth as a product of inflammation (released by various inflammatory cells) as well as mediator of inflammatory responses. There has been a sudden surge in zygomycetes infection particularly of the order mucorales. Mucormycosiscaused by Rhizopusoryzae sis a life threatening infection seen in covid-19 patients. A novel mechanism in pathogenesis of mucormycosis is iron acquisition.

References

REFERENCES
1. Kent S, Dunn D. Etiology of hypoferremia in a recently sedentary Kalahari village. Am J Trop Med Hyg. 1993 Apr 1;48(4):554-67. doi: 10.4269/ajtmh.1993.48.554, PMID 8480865.
2. Recalcati S, Invernizzi P, Arosio P, Cairo G. New functions for an iron storage protein: the role of ferritin in immunity and autoimmunity. J Autoimmun. 2008 Feb 1;30(1-2):84-9. doi: 10.1016/j.jaut.2007.11.003, PMID 18191543.
3. Tran TN, Eubanks SK, Schaffer KJ, Zhou CY, Linder MC. Secretion of ferritin by rat hepatoma cells and its regulation by inflammatory cytokines and iron. Blood. 1997 Dec 15;90(12):4979-86. PMID 9389717.
4. Fan Y, Yamada T, Shimizu T, Nanashima N, Akita M, Suto K, Tsuchida S. Ferritin expression in rat hepatocytes and Kupffer cells after lead nitrate treatment. Toxicol Pathol. 2009 Feb;37(2):209-17. doi: 10.1177/0192623308328544, PMID 19332663.
5. Zager RA, Johnson AC, Hanson SY. Parenteral iron nephrotoxicity: potential mechanisms and consequences. Kidney Int. 2004 Jul 1;66(1):144-56. doi: 10.1111/j.1523-1755.2004.00716.x, PMID 15200421.
6. Ferring-Appel D, Hentze MW, Galy B. Cell-autonomous and systemic context-dependent functions of iron regulatory protein 2 in mammalian iron metabolism. Blood. 2009 Jan 15;113(3):679-87. doi: 10.1182/blood-2008-05-155093, PMID 18922858.
7. Kernan KF, Carcillo JA. Hyperferritinemia and inflammation. Int Immunol. 2017 Sep;29(9):401-9. doi: 10.1093/intimm/dxx031, PMID 28541437.
8. Ruddell RG, Hoang‐Le D, Barwood JM, Rutherford PS, Piva TJ, Watters DJ, Santambrogio P, Arosio P, Ramm GA. Ferritin functions as a proinflammatory cytokine via iron‐independent protein kinase C zeta/nuclear factor kappaB–regulated signaling in rat hepatic stellate cells. Hepatology. 2009 Mar;49(3):887-900. doi: 10.1002/hep.22716, PMID 19241483.
9. Broxmeyer HE, Williams DE, Geissler K, Hangoc G, Cooper S, Bicknell DC, Levi S, Arosio P. Suppressive effects in vivo of purified recombinant humanH-subunit (acidic) ferritin on murine myelopoiesis. Blood. 1989;73(1):74-9, PMID 2910370.
10. Fargion S, Fracanzani AL, Brando B, Arosio P, Levi S, Fiorelli G. Specific binding sites for H-ferritin on humanlymphocytes: modulation during cellular proliferation and potentialimplication in cell growth control. Blood. 1991;78(4):1056-61, PMID 1831058.
11. Behrens EM, Canna SW, Slade K, Rao S, Kreiger PA, Paessler M, Kambayashi T, Koretzky GA. RepeatedTLR9 stimulation results in macrophage activation syndrome-likedisease in mice. J Clin Invest. 2011;121(6):2264-77. doi: 10.1172/JCI43157, PMID 21576823.
12. Ibrahim AS, Spellberg B, Edwards Jr J. Iron Acquisition: a novel prospective on mucormycosis pathogenesis and treatment. Curr Opin Infect Dis. 2008 Dec;21(6):620-5. doi: 10.1097/QCO.0b013e3283165fd1, PMID 18978530.
13. Thieken A, Winkelmann G. Rhizoferrin: a complexone type siderophore of the mocorales and Entomophthorales (Zygomycetes). FEMS Microbiol Lett. 1992 Jul 1;94(1-2):37-41. doi: 10.1111/j.1574-6968.1992.tb05285.x, PMID 1387861.
14. Boelaert JR, de Locht M, Van Cutsem J, Kerrels V, Cantinieaux B, Verdonck A, Van Landuyt HW, Schneider YJ. Mucormycosis during deferoxamine therapy is a siderophore-mediated infection. In vitro and in vivo animal studies. J Clin Invest. 1993 May 1;91(5):1979-86. doi: 10.1172/JCI116419, PMID 8486769.
Published
2022-01-08
How to Cite
sarah. (2022). Is Ferritin one of The Missing Link in Putting Together the Pieces of Covid 19 and Mucormycosis?. UNIVERSITY JOURNAL OF DENTAL SCIENCES, 8(1). https://doi.org/10.21276//ujds.2022.8.1.26