Brain Iron Dysregulation in Iron Deficiency Anemia-Related Restless Leg Syndrome Revealed by Neuron-Derived Extracellular Vesicles: A Case–Control Study
Apostolos Manolopoulos, MD ,1 William York, BS,1 Krishna Ananthu Pucha, BS,1 Christopher J. Earley, MBBCh, PhD,2 and Dimitrios Kapogiannis, MD1
This is a bit complicated so I will cut and paste some excerpts from the paper. It does not give us much to go on as treatment but it is good to see they are looking for why RLS suffers have low brain iron. NDEV = Neuronal Derived Extracellular vesicles. Basically the nerves are spitting out the iron they have!
TfR = transferrin receptor, the primary cellular iron importer. So the nerves are not as good at getting the iron in.
Collectively, our findings suggest a pathogenic mechanism for intracellular iron depletion through secretion of NDEVs laden with H-ferritin.
the finding of lower NDEV TfR levels in RLS could be interpreted as evidence for diminished capacity of neurons to import iron. In the face of increased ferritin loss through EV secretion, decreased TfR on the cell surface would render neurons unable to mount a compensatory response to restore the intracellular iron levels. Taken together, our findings sug- gest that NDEV abnormalities are not incidental but reflect a coordinated perturbation of homeostatic mecha- nisms that regulate neuronal iron influx and efflux.
Our findings inform a more complete understanding of the role of iron homeostasis in RLS pathogen- esis and help dissociate it from peripheral ID. Future mechanistic studies are warranted to investigate how iron regulatory proteins in neuronal cells and secreted NDEVs may relate to each other and respond to iron changes.
So as we know, the brain iron level is dependent of the iron regulation in the rest of the body. I explain the benefit, to many, of oral/IV iron is that having more in you blood gives a better oportunity for it to get into the brain via its weaker than normal absorption ability. Dont make it harder by having low iron.
Good news that there is research getting done on the cause, it is really complicated!