Modulation of brain iron by local hepcidin in prion disorders

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Prion disorders are infectious and invariably fatal neurodegenerative conditions associated with accumulation of PrP-scrapie (PrPSc), a β-sheet rich isoform of the normal prion protein (PrPC), in the brain and retina of humans and certain animal species. Sporadic Creutzfeldt-Jakob-disease (sCJD) is the most common human prion disorder, and PrPSc-infected animal models are used to understand the mechanism of infectivity and toxicity. Neuroinflammation and iron accumulation are consistent features of these disorders, the latter contributing to neurotoxicity by iron-catalyzed reactive oxygen species (ROS). The cause of iron accumulation, however, has remained elusive. Recent data from my laboratory suggest cytokine-mediated upregulation of hepcidin synthesized by astrocytes as a significant cause. Hepcidin regulates iron by downregulating ferroportin (Fpn), the only known iron export protein. Under normal conditions, hepcidin is upregulated when iron saturation of transferrin (Tf-Fe) is low. Upregulation by cytokines, however, supersedes the signal from Tf-Fe. It is likely that cytokine-mediated upregulation of hepcidin by astrocytes is the cause of iron neuronal accumulation that express Fpn on their plasma membrane, and toxicity by ROS. In support of this hypothesis, sCJD brain homogenates show upregulation of hepcidin mRNA and protein, downregulation of Fpn, and increase in ferritin. Likewise, brain homogenates from PrPSc-infected mice show upregulation of hepcidin mRNA, and retinal sections from PrPSc- infected hamsters show activation of microglia before or concomitant with upregulation of ferritin during disease progression. Based on these observations, we hypothesize that iron accumulation in sCJD and PrPSc-infected brains and retina results from cytokine-mediated upregulation of local hepcidin. Two specific aims are proposed to test this hypothesis. In aim 1, additional sCJD brain and retinal tissue will be checked for increase in hepcidin mRNA and accumulation of iron, and correlated with neuronal and retinal ganglion cell (RGC) death in immunostained sections. In addition, the brain and retina of PrPSc-infected mice will be examined during disease progression to explore if increase in cytokines precedes upregulation of hepcidin and iron accumulation, and whether retinal degeneration precedes neurodegeneration. This will pave the way for retinal imaging a pre- clinical diagnostic test for sCJD. In aim 2, the role of hepcidin in brain and retinal iron accumulation will be further explored using hepcidin knock-out (hepc-/-) and littermate (hepc+/+) control mice inoculated with PrPSc. A significant decrease in iron accumulation in hepc-/- mice relative to hepc+/+ controls despite similar increase in cytokines and PrPSc load with disease progression will suggest local hepcidin as the cause of iron accumulation. Moreover, a marked reduction in neuronal and RGC death in hepc-/- mice will suggest a significant role of iron in inducing neurotoxicity, and justify the use of hepcidin antagonists and Fpn stabilizing agents to reduce accumulated iron as therapeutic options. No change in iron levels in hepc-/- mice will refute our hypothesis, and suggest iron as an epiphenomenon of the disease process.