Anemia of Inflammation is a prevalent co-morbidity in patients with chronic inflammatory disorders.

Inflammation causes hypoferremia and iron-restricted erythropoiesis by limiting Ferroportin (Fpn)-

mediated iron export from macrophages that recycle senescent erythrocytes. Macrophage cell surface

expression of Fpn is reduced by hepcidin-induced degradation and/or by repression of Fpn (Slc40a1)

transcription via cytokine and Toll-like receptor (TLR) stimulation. While the mechanisms

underlying hepcidin-mediated control of Fpn have been extensively studied, those inhibiting Slc40a1

mRNA expression remain unknown. We applied targeted RNA interference and pharmacological screens in

macrophages stimulated with the TLR2/6 ligand FSL1 and identified critical signalling regulators of

Slc40a1 mRNA repression downstream of TLRs and NFкB signaling. Interestingly, the NFкB regulatory

hub is equally relevant for Slc40a1 mRNA repression driven by the TLR4 ligand LPS, the cytokine

TNFβ/LTA and heat-killed bacteria. Mechanistically, macrophage stimulation with heat-killed

Staphylococcus aureus recruits the Histone deacetylases (HDAC) 1 and 3 to the antioxidant response

element (ARE) located in the Slc40a1 promoter. Accordingly, pre-treatment with a pan-HDAC inhibitor

abrogates Slc40a1 mRNA repression in response to inflammatory cues, suggesting that HDACs act

downstream of NFкB to repress Slc40a1 transcription. Consistently, recruitment of HDAC 1 and 3 to

the Slc40a1 ARE following stimulation with heat-killed Staphylococcus aureus is dependent on NFκB

signaling. These results support a model in which the ARE integrates the transcriptional responses

of Slc40a1 triggered by signals from redox, metabolic and inflammatory pathways. This work

identifies the long-sought mechanism of Slc40a1 transcriptional downregulation upon inflammation,

paving the way for therapeutic interventions at this critical juncture.

Disclosures

No relevant conflicts of interest to declare.

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