Abstract
Circulating ferritin levels reflect body iron stores and are elevated with inflammation in chronic liver injury. H-ferritin exhibits a number of extrahepatic immunomodulatory properties although its role in hepatic inflammation and fibrogenesis is unknown. Hepatic stellate cells respond to liver injury through production of proinflammatory mediators which drive fibrogenesis. A specific receptor for ferritin has been demonstrated on activated hepatic stellate cells although its identity and its role in stellate cell activation is unclear. We propose that ferritin acts as a cytokine regulating proinflammatory function via NFκB-regulated signaling in hepatic stellate cell biology. Hepatic stellate cells were treated with tissue ferritin, and iron-free apoferritin, recombinant H- and L-ferritins to assess the role of ferritin versus ferritin-bound iron in the production of proinflammatory mediators of fibrogenesis, and to determine whether signalling pathways elicited act via a proposed H-ferritin endocytosis receptor, T cell immunoglobulin-domain and mucin-domain 2 (Tim-2). This study demonstrated that ferritin activates an iron-independent signaling cascade, involving Tim-2-independent PI3-kinase phosphorylation, PKCζ and p44/p42-MAP-kinase resulting in p50/p65-NFκB activation and markedly enhanced expression of hepatic proinflammatory mediators IL-1β, iNOS, RANTES, IκBα and ICAM1.
Conclusions
This study has defined the role of ferritin as a proinflammatory mediator of hepatic stellate cell biology acting through the NFκB signaling pathway, and suggests a potential role in the inflammatory processes associated with hepatic fibrogenesis.
Keywords: Hepatic fibrosis, hemochromatosis, Interleukin-1β, ICAM-1, RANTES
Tissue ferritin is an important site for the physiological storage of iron in a non-toxic but biologically available form. The ferritin molecule is comprised of 24 subunits of two structurally distinct subunit types: the acidic, heavy or H-chain and the basic, light or L-chain. H-ferritin has been shown to regulate immune function, hematopoiesis, hepatocyte apoptosis and cell differentiation (reviewed in (1)). Ferritin is measured in the serum as an indicator of body iron stores and when grossly elevated is indicative of disease severity in patients with hemochromatosis (2). Circulating ferritin levels are also elevated in inflammation and are known to be regulated by proinflammatory cytokines (3). The mechanisms by which inflammatory cytokines regulate ferritin are the focus of much study (reviewed in (1)), however, the explanation for why and how circulating ferritin is elevated during inflammation and its potential role in chronic injury are unknown.
Chronic liver diseases, leading to fibrosis and cirrhosis are commonly associated with inflammation and elevated serum ferritin (4, 5). Inflammatory mediators such as TNFα and IL-1α contribute directly to elevated ferritin levels (1) and the activation of the profibrogenic hepatic stellate cell (HSC; (6)). Previous studies have demonstrated a very high affinity, specific receptor for ferritin on activated HSC and shown that the binding of ferritin to the HSC is dependent on H-ferritin (7, 8). Further studies demonstrated a role for ferritin in regulating the expression of α-smooth muscle action (αSMA), a key marker of activated HSC (8). However, the role of ferritin in regulating the processes associated with HSC activation and subsequent fibrogenesis have not been previously investigated. Hepatic fibrosis is characterised by the transformation of quiescent HSC to a myofibroblastic phenotype exhibiting proliferative and proinflammatory characteristics. HSC also migrate to the site of hepatic injury in response to various chemokines and cytokines (6) and at the site of injury HSC are directly responsible for the deposition of extracellular scar matrices such as collagens I, III and IV, fibronectin, elastin and laminin (6).
The transcription factor nuclear factor kappa B (NFκB), has been shown to play a crucial role in HSC survival and the wound-healing and inflammatory response of both parenchymal and non-parenchymal cells to hepatic injury (9). In addition, elevated hepatic NFκB activation has been demonstrated to correlate with hepatic inflammation and fibrosis in human alcoholic liver disease (10). With this knowledge, together with the growing realization that ferritin mediates an array of cellular functions, it is not unreasonable to hypothesize that ferritin may play a role in the processes associated with HSC activation and the subsequent hepatic inflammatory response in chronic liver disease. In this study we describe the role of ferritin as a proinflammatory mediator in activated rat HSC acting through the NFκB signaling pathway. We show for the fist time that ferritin activates an iron-independent signaling cascade involving PI3-kinase, PKCζ, MEK-1/2 and p44/p42 MAP-kinase resulting in the activation of p50/p65 NFκB and the significantly enhanced expression of hepatic proinflammatory and profibrogenic mediators IL-1β, iNOS, RANTES, IκBα and ICAM1.
Methods
Hepatic Stellate Cell Isolation
Studies were performed with institutional Animal Ethics Committee approval and compliance with Australian regulatory guidelines. Rat HSC were isolated from normal male Sprague-Dawley rats (600±50g) by sequential pronase/collagenase perfusion, cultured on plastic 12-well plates and grown in Medium 199 (Invitrogen) supplemented with 10% calf + 10% horse serum, 50μg/mL ascorbic acid and penicillin/streptomycin (100U and 100μg/mL, respectively), to induce an activated phenotype (11, 12). In addition, isolated HSC were cultured on Teflon® tissue culture inserts (Millipore) to maintain cells in a quiescent phenotype (11). 24hr prior to experimentation, HSC were washed and cultured in serum-free M199 medium. HSC were then treated with either the iron-replete tissue ferritins horse spleen or rat liver ferritin (termed “ferritin”) (Sigma-Aldrich), the iron-free recombinant human H-(rHF) or L-subunit (rLF) ferritins, or with de-ironed ferritin (apoferritin). Recombinant ferritins rHF and rLF (13), and apoferritin (7, 8) were prepared as described. Five day culture-activated HSC were routinely used except where indicated.
SDS-Polyacrylamide Gel Electrophoresis
Whole cell protein extracts were prepared by lysis of HSC cultures in 1X SDS sample buffer (62.5mM Tris HCl pH6.8, 2% w/v SDS, 10% glycerol, 50mM DTT, 0.01% w/v bromophenol blue). 25μL cell protein was subjected to SDS-PAGE and western blot using specific antibodies, with detection of antigen using the ECL system (GE), as described (11). Digital images of blots were captured using the FUJIFILM LAS3000 system and analyzed using FUJIFILM Multi Gauge V3.0 software.
Extraction of RNA from HSC
Subconfluent (80-90%) rat HSC were washed with ice-cold PBS and placed on ice prior to total RNA isolation using the RNeasy mini kit (Qiagen) as per manufacturer's instructions. Total RNA was then treated with 1μL of RQ1 RNase free DNase I (1U/μL Promega) per 1 μg of total RNA for 30min at 37°C to ensure complete removal of DNA contamination. Total RNA concentration and quality was estimated by spectrophotometry at 260-280nm.
Quantitative Real-Time RT-PCR
3μg of total RNA was used to generate complementary cDNA template using an oligodT15 primer and SuperScript III™ (Invitrogen). Real time PCR reactions were performed in a final volume of 15μL with forward and reverse oligonucleotide primers (Table 1) used at a final concentration of 500nM, using Platinum® SYBR® Green qPCR SuperMix-UDG (Invitrogen) and the reaction profile as recommended by the manufacturer. All PCR reaction efficiencies were between 0.95-1.10. Melt curve analysis revealed the presence of a single product with a single melt signature. PCR was performed using an RG-3000 thermal cycler (Corbett Research Australia). mRNA quantitation was achieved using the two standard curves method, with the fluorescence measurements of the unknown samples back-referenced to a standard curve relating concentration to fluorescence in arbitrary units. mRNA levels were normalized to expression of the housekeeping gene Basic Transcription Factor 3 (BTF3) and expressed relative to untreated or control samples (presented as relative mRNA expression).
Table 1.
Details of the oligonucleotide primers used in the real time PCR assays
| Rat Gene | Accession Number | Forward Primer Sequence | Reverse Primer Sequence |
|---|---|---|---|
| IL-1β | NM_031512 | ATCCCAAACAATACCCAAAGAAGAA | TGGGGAACTGTGCAGACTCAAAC |
| RANTES | NM_031116 | TGCCCACGTGAAGGAGTATTTTTA | TGGCGGTTCCTTCGAGTGACAA |
| iNOS | NM_012611 | AGGGAGTGTTGTTCCAGGTG | TCTGCAGGATGTCTTGAACG |
| ICAM1 | NM_012967 | TGATCATTGCGGGCTTCGTG | GGCGGGGCTTGTACCTTGAGT |
| IκBα | NM_001105720 | GCTGACCCTGGAAAATCTT | GTCATCGTAGGGCAACTCATC |
| αSMA | NM_031004 | GGCCACTGCTGCTTCCTCTTCTT | TGCCCGCCGACTCCATTC |
| Collagenα1(I) | NM_053304 | GCCCAAACCCCAAGGAGAAAAA | GGACATCAGGCGCAGGAAGG |
| BTF3 | NM_001008309 | TGGCAGCAAACACCTTCACC | AGCTTCAGCCAGTCTCCTCAAAC |
Nitric Oxide Determination
Freshly isolated HSC were cultured with ferritin (100pM-100nM). At days 3, 5 and 7, culture medium was harvested and at days 3 and 5 replaced with fresh medium containing ferritin. The concentration of the stable and non-volatile breakdown product of nitric oxide, (NO2- nitrite) in the conditioned medium was then determined using the Griess Reagent System (Promega) as per manufactures instructions.
Immunoprecipitation
Day 5 culture-activated HSC were incubated with rHF, rLF or ferritin for 1hr. Cells were then lyzed for immunoprecipitation studies as per manufacturer's instructions (Roche). 500μL of cell lysate was pre-cleared for 3hr with 25μL of the homogeneous protein-A-agarose suspension before immunoprecipitation with the rabbit anti-phospho-YXXM PI3-kinase target motif (Cell Signaling Technology, 1:100) at 4°C overnight. Immunoprecipitate was washed and the resultant bead-antibody-protein complex resuspended in 1X SDS sample buffer and boiled for 3min. Beads were pelleted by brief centrifugation and the supernatant resolved using 9% SDS PAGE. After transfer to Nitrocellulose, blots were probed with goat anti-mouse antibody to T cell immunoglobulin-domain and mucin-domain 2 (Tim-2) (R&D Systems, 1:1250 in 5% SMP blocking buffer) overnight at 4°C. Primary antibodies were detected using a rabbit anti-goat IgG antibody conjugated to HRP (Sigma, 1:1000 in 5% SMP blocking buffer).
Electrophoretic Mobility Shift Assay (EMSA)
The consensus double stranded NFκB binding site oligonucleotide (5'-AGT TGA GGG GAC TTT CCC AGG C-3' Promega) was 5'-end-labelled with [γ-32P]ATP (3000 Ci/mmol-1; Amersham Pharmacia Biotech) using T4 polynucleotide kinase (New England Biolabs®). Nuclear extracts were prepared as described (14) and protein content determined using the Lowry method with Peterson's modification (Sigma). EMSA was performed as described (15) with protein/DNA complexes resolved on 8% non-denaturing polyacrylamide gel (37:5:1). For supershift analysis of NFκB subunits, 2μg of anti-p50 and anti-p65 antiserum (Santa Cruz) were added after the initial oligonucleotide probe and nuclear extract reactions, and incubated at room temperature for 1hr.
Statistical Analysis
Data are presented as mean values of 3-4 separate experiments performed in duplicate ± SEM. Groups were compared using One-way ANOVA with Dunnett's multiple comparison post hoc test or the Student t-test, where applicable using Prism 4.0 (GraphPad Software). P<0.05 was considered statistically significant.
Results
Ferritin activates NFκB in activated rat HSC
Given the role NFκB plays in mediating the inflammatory response of HSC, the potential for ferritin to influence this inflammatory response was assessed by investigating its effect on NFκB activity. Ferritin induced a significant dose-dependent increase in IKK α/β phosphorylation (Figure 1A,B). An optimal ferritin concentration of 10nM was chosen, giving maximal effects on IKK phosphorylation, with no effect on cell viability. HSC incubated with 10nM ferritin demonstrated a significant time-dependent, transient increase in IKKα/β phosphorylation with maximal expression of 4.3-fold after 120min (Figure 1C,D). The binding of nuclear extracts from HSC treated with ferritin to consensus NFκB binding sites was analysed by EMSA. NFκB DNA-binding activity was increased within 5min, peaking at 6hr, returning to basal levels by 24hr (Figure 1E-G). EMSA supershift revealed NFκB upregulated by ferritin contained both p50 and p65 subunits (data not shown).
Figure 1. Ferritin induces the phosphorylation of IKKβ/βand activation of NFκB in activated rat HSC.



Day 5 activated rat HSC were cultured with increasing concentrations of ferritin (A, B) for 1 hour, or with 10nM ferritin for 0-240 minutes (C, D) before IKKα/β phosphorylation was assessed by western blotting. Induction of IKKα/β phosphorylation by ferritin was both dose- and time-dependent (ANOVA, P=0.043 and P=0.04; respectively). IKKα/β phosphorylation was maximally induced after 120 minutes incubation with 10nM ferritin (P<0.05). Day 5 activated HSC were also incubated with 10nM ferritin for 0-24 hours and nuclear extracts subjected to EMSA and densitometric analysis (E-G). Ferritin rapidly induced a 2-fold increase in NFκB DNA-binding activity in a time-dependent manner in short-term (60 minutes) exposure (F; ANOVA, P=0.0059), peaking at 6 hours, and remained significantly elevated and time-dependent for up to 18 hours (G; ANOVA, P=0.0007) before returning to control levels by 24 hours. ⋆ & ⋆⋆ Indicates a significant difference from the control untreated cell population (P<0.05 and P<0.01, respectively). Data is expressed as mean value of three separate experiments performed in duplicate ± SEM.
Ferritin induces NFκB-responsive proinflammatory genes
The consequences of ferritin-induced NFκB DNA-binding activity were then assessed. Activated HSC were treated with 0-100nM ferritin for 0-240min. Ferritin induced a significant dose- (Figure 2A) and time-dependent (Figure 2B-E) increase in expression of NFκB-transcriptionally regulated genes known to play a role in mediating hepatic fibrogenesis (15-19); including ICAM1 (5.24±0.72 fold; Figure 2B), IκBα (3.54±0.73 fold; Figure 2C), iNOS (92.42±37.20 fold; Figure 2D), IL-1β (48.10±8.30 fold; Figure 2E) and RANTES (37.84±14.32 fold; results not shown) after 2-4hr. The effect of ferritin was most evident when using 5-100nM ferritin (Figure 2A). The sensitivity of activated HSC to ferritin was reflected in the EC50 values (Table 2). Ferritin had no effect on the expression of HSC activation markers procollagen α1(I) or αSMA mRNA (results not shown).
Figure 2. Incubation of activated rat HSC with ferritin increased the transcription of NFκB-responsive genes in both a time- and dose-dependent manner.


Quiescent and day 5 culture-activated rat HSC were treated with 1-100nM ferritin for 3 hours prior to analysis of NFκB-transcriptionally regulated gene expression by quantitative real-time RT-PCR. Incubation of day 5 activated HSC with increasing concentrations of ferritin (1-100nM) for 3 hours enhanced the expression of ICAM1, IκBα, RANTES and IL-1β mRNA in a dose dependent manner (A, ANOVA P<0.001 for all genes) and subsequent EC50 values can be see in Table 2. A time-dependent increase in the mRNA expression of ICAM1 (ANOVA, P<0.0001; B), IκBα (ANOVA, P=0.0013: C), iNOS (ANOVA, P=0.0079: D) and IL-1β (ANOVA, P<0.0001; E) was also observed following incubation of day 5 HSC with 10nM ferritin for between 15 and 240 minutes. The expression of RANTES, ICAM1 and IκBα in quiescent HSC was not significantly altered by ferritin, although IL-1β expression was increased by 2.5-fold using 100nM ferritin only (F). Pre-treatment of day 5 activated HSC with 10 µM Bay11-7082 (an inhibitor of cytokine-induced IκBα phosphorylation) for 1 hour prior to the incubation of HSC with 10nM ferritin in the continued presence of Bay11-7082 was able to completely block (~100 %) the increased mRNA expression of IL-1β induced by ferritin (P<0.001, G). ⋆⋆ & ⋆⋆⋆ indicate a significant difference of the indicated mean values (P<0.01 and P<0.001 respectively). Data is expressed as mean value of three separate experiments performed in duplicate ± SEM
Table 2.
Calculated EC50 values for the dose dependent effects of ferritin on activated rat HSC.
| Gene | Ferritin EC50 (nM) |
|---|---|
| ICAM1 | 3.84 |
| IκBα | 3.80 |
| RANTES | 27.54 |
| IL-1β | 10.16 |
Teflon®-cultured (quiescent) HSC were incubated with ferritin (1-100nM) for 3hr. Ferritin had no effect on RANTES, ICAM1, IκBα expression and only 100nM ferritin induced IL-1β (2.5 fold; Figure 2F). αSMA and procollagen α1(I) expression was also unaffected (data not shown).
To further confirm the role of NFκB in ferritin-induced signaling in activated HSC, IκBα phosphorylation (therefore NFκB activation) was blocked using the specific inhibitor Bay11-7082 (20), and the ferritin-induced expression of IL-1β mRNA assessed. IL-1β transcription stimulated by 10nM ferritin was completely inhibited by Bay11-7082 (Figure 2G), confirming that ferritin induced IL-1β via IκBα phosphorylation and NFκB activation.
Ferritin induces ICAM1, IκBα and Nitric Oxide production
10nM ferritin induced a significant time-dependent increase in ICAM1 protein expression in activated HSC after 24hr (1.52±0.11 fold) and 48hr (1.93±0.15 fold) (Figure 3A,B). IκBα protein levels were also increased by ferritin (Figure 3A). Nitric Oxide produced by ferritin-treated HSC was assessed as a functional consequence of iNOS mRNA induction. Ferritin induced a significant dose-dependent increase in Nitric Oxide production after 3d and 5d with maximal increases of 3.22±0.78 and 4.78±1.36 fold, respectively (Figure 3C). After 7 days Nitric Oxide production returned to basal levels (Figure 3C).
Figure 3. Incubation of activated rat HSC induces the expression of ICAM1 and IκBα protein and the production of Nitric Oxide.

Day 5 culture-activated HSC were incubated with 10nM ferritin for 0-48 hours with culture medium including ferritin replenished after 24 hours. Whole cell protein extracts were subjected to western blot analysing the expression of ICAM1 and IκBα protein (A). There was a significant time-dependent increase in the expression of ICAM1 protein (ANOVA, P=0.0001; B). IκBα was also increased in a time-dependent manner although this did not reach statistical significance. Additionally HSC were culture-activated on plastic in the presence of ferritin (0-100nM) for up to 7 days (C), with clture media containing ferritin replenished at days 3 and 5. At days 3, 5 and 7 the concentration of the stable Nitric Oxide breakdown product, Nitrite (NO -2) was determined using the Griess Reagent system (C). Ferritin induced a significant dose-dependent increase in Nitric Oxide production at day 3 (ANOVA P=0.0174) and day 5 (ANOVA P=0.0052), returning to basal levels after 7 days. ⋆ and ⋆⋆ indicate a significant difference of the indicated mean values from control untreated samples (P<0.05 and P<0.01 respectively). Data shown here is expressed as mean values ± SEM derived from 4 separate experiments performed in duplicate.
Rat HSC express Tim-2
Recent data suggests that Tim-2 acts as a receptor for H-ferritin endocytosis in B cells (21), although its role in initiating cell signaling is not known. We investigated the expression of Tim-2 in HSC. Western blot revealed two Tim-2 bands in quiescent HSC (Figure 4A). Tim-2 expression (both bands) was unchanged with time as HSC became activated (Figure 4A,B), as evidenced by the upregulation of αSMA, a marker of HSC activation (Figure 4A).
Figure 4. Rat HSC express Tim-2 from quiescence to activation.

Rat HSC were isolated and culture-activated in plastic tissue culture wells. At regular 24 hour time periods up to and including day 6 post-isolation, whole cell proteins were extracted and analysed for the presence of Tim-2. Anti-Tim-2 antibody identified two bands - the upper band was the same 48 kDa molecular weight (arrow) of Tim-2 as seen in immunoprecipitation experiments outlined in Figure 5C, the lower band potentially representing a molecular weight variant (A). Both protein bands were quantitated and the combined result for Tim-2 protein was expressed relative to time in culture (B). Tim-2 expression was demonstrated in quiescent HSC (day 0-1) and expression levels remained unchanged over the duration of HSC activation, indicated by increasing expression of αSMA. This result did not change when upper and lower Tim-2 bands were analysed separately (data not shown). Data is expressed as mean value of four separate experiments performed in duplicate ± SEM.
PI3-kinase is activated by ferritin
Contained within the Tim-2 amino acid sequence is a consensus PI3-kinase target phosphorylation motif (YXXM) (21). Thus, we investigated the potential role of Tim-2 and PI3-kinase in mediating the NFκB-transcriptional events triggered by ferritin. Activated HSC were incubated with 10nM ferritin for 0-240min before cell protein extracts were subjected to western blot (Figure 5A). A significant relationship between YXXM phosphorylation (i.e. all proteins with phospho-YXXM-motif, PI3-kinase target site) and ferritin exposure time was observed with maximal increase of 2.87±0.31 fold at 120min (Figure 5B). rHF and rLF induced similar increases in YXXM phosphorylation (data not shown). To assess whether Tim-2 was one of these phosphorylated proteins, we immunoprecipitated all proteins that had undergone YXXM phosphorylation in response to treatment with either ferritin, rHF or rLF, and probed for Tim-2 (Figure 5C). No difference in phospho-Tim-2 expression was observed 1hr after treatment of activated HSC with 10nM ferritin, rHF or rLF. This suggests that Tim-2, acting through PI3-kinase, is not involved in ferritin-induced signaling. To further assess the role of PI3-kinase in ferritin-induced NFκB-gene transcription, the PI3-kinase inhibitor wortmannin was used (22). Wortmannin (100nM) alone had no effect on IL-1β mRNA expression, however, wortmannin significantly inhibited the ferritin-induced expression of IL-1β by 78.4 % (Figure 5D).
Figure 5. Ferritin activates PI3-kinase in activated rat HSC.


Day 5 culture-activated HSC were incubated with 10nM ferritin for 0-240 minutes before whole cell protein was extracted and subjected to western blotting. YXXM motif phosphorylation was assessed using polyclonal rabbit antibodies raised specifically to the phosphorylated Tyr residue in the YXXM motif (A). Ferritin induced a time-dependent increase in the level of YXXM phosphorylation (ANOVA, P=0.0014; B), i.e. all proteins with phosphorylated-YXXM-motif (PI3-kinase target site), peaking at 120 minutes. In order to assess Tim-2 phosphorylation in response to ferritin, activated HSC were treated with 10nM ferritin, iron-free recombinant H-ferritin (rHF) or iron-free recombinant L-ferritin (rLF) for 1 hour, whole cell protein extracts were then subjected to immunoprecipitation using an anti phospho-YXXM PI3-kinase target motif. Following SDS-PAGE resolution and transfer, proteins were probed for the presence of Tim-2 using a mouse anti-Tim-2 Ab (C). None of the ferritin molecules used had any effect on the levels of Tim-2 phosphorylation, suggesting that Tim-2 acting through PI3-kinase is not involved in the signalling pathway elicited by ferritin in HSC. Day 5 culture-activated HSC were also incubated with 100nM wortmannin (Wort), a PI3-kinase inhibitor, for 1 hour prior to treatment with 10nM ferritin for 3 hours with continued wortmannin culture medium presence; transcription of the IL-1β gene was then assessed using quantitative PCR (D). 100nM wortmannin significantly blocked the ferritin induced of IL-1β gene transcription by 80 %. ⋆⋆ and ⋆⋆⋆ indicate a significant difference of the indicated mean values or from control untreated samples (P<0.01 and P<0.001 respectively). Data is expressed as mean value of three separate experiments performed in duplicate ± SEM.
Ferritin is a PKCζ activator
PKCζ, a downstream target of PI3-kinase, is intimately involved in NFκB activation (23). As As ferritin activates both PI3-kinase and NFκB, we investigated the role of PKCζ in the ferritin-induced signaling events. Ferritin induced the time-dependent phosphorylation of PKCζ (Figure 6A,B). Significant enhancement of PKCζ phosphorylation (4.19±0.24 fold) by ferritin was evident after 30min, which increased until 120min (5.78±1.0 fold). Using a pseudosubstrate inhibitor of PKCζ (100 μM) we attempted to block the effects of ferritin on IL-1β gene transcription (Figure 6C). Two variants of the PKCζ pseudosubstrate inhibitor were used; the first was myristoylated (M) to allow cell entry, the second non-myristoylated (NM; ie, non-cell permeable), serving as a control (Figure 6C). The M-PKCζ pseudosubstrate inhibitor completely abolished the effects of ferritin on IL-1β transcription; conversely, the NM-PKCζ pseudosubstrate inhibitor control had no effect. To further assess the role of ferritin as a PKC-ζ activator, activated HSC were exposed to ferritin (10fM-100nM) for up to 7d. Long-term treatment with PKC activators has been shown to cause PKC down-regulation in fibroblasts (24). Ferritin induced a dose-dependent decrease in expression of the 80kDa, or phosphorylated form of PKCζ becoming significant at 10pM (51.5±8.0% decrease), with expression undetectable using 100nM ferritin (Figure 6D). This provides further strong support for the role of ferritin as a PKC-ζ activator in HSC biology.
Figure 6. PKCζ is activated by ferritin in activated rat HSC.


Day 5 culture-activated HSC were incubated with 10nM ferritin for 0-120 minutes. Whole cell protein extracts were isolated and subjected to western blotting (A). Ferritin elicited a time-dependent increase in the level of PKCζ phosphorylation (ANOVA, P=0.0042, B), with a 6-fold elevation evident after 120 minutes. To block potential ferritin-induced signalling events, activated HSC were also incubated with 100 μM myristoyl (M, cell permeable) or non-myristoyl (NM, non-cell permeable) PKCζ pseudosubstrate inhibitor for 1 hour prior to treatment with 10nM ferritin and for 3 hours in the continued presence of the M or NM PKCζ pseudosubstrate inhibitor, to assess the role of PKC-ζ in ferritin-induced IL-1β gene expression (C). M- but not NM-PKCζ pseudosubstrate inhibitor completely abolished the effects of ferritin on IL-1β gene expression. To assess the long term effects of ferritin on HSC, freshly isolated rat HSC were culture-activated on plastic and treated with ferritin (10fM - 100nM) for 7 days. Culture medium containing ferritin was replenished at days 3 and 5. Whole cell protein extracts were isolated at day 7 and subjected to western blot for PKCζ (D). The 80 kDa (phosphorylated) PKCζ subunit was observed to undergo a dose-dependent decrease in expression (ANOVA, P=0.0002) where as the expression of the 66 kDa subtype remained unchanged. ⋆ and ⋆⋆ indicate a significant difference of the indicated mean values or from control untreated samples (P<0.05 and P<0.01). Data is expressed as mean value of four separate experiments performed in duplicate ± SEM.
Ferritin induces the phosphorylation of MAP-kinase
MAP-kinase is a downstream target of PKCζ and an activator of NFκB (25), thus we investigated the role of MAP-kinase in ferritin-induced signaling. Treatment of day 5 activated HSC with ferritin (10pM-100nM) for 1hr caused a significant dose-dependent increase in MAP-kinase phosphorylation (Figure 7A,B). Maximal MAP-kinase p42/p44 phosphorylation was observed using 100nM ferritin (7.7±0.62 and 16.9±2.65 fold, respectively). Figures 7C,D demonstrate the time-dependent increase in MAP-kinase p42/p44 phosphorylation following ferritin treatment. Maximal expression was observed after 60min (2.23±0.41 and 2.83±0.35 fold, respectively), returning to basal levels after 4hr (Figure 7C,D). Similar effects were observed using rHF and rLF (data not shown). To further assess the role of MAP-kinase in ferritin-induced signalling, HSC were treated with 10nM ferritin + U0126 (10μM, 30min), a selective inhibitor of MEK1/2 (a known activator of MAP-kinase), and IL-1β expression assessed. Ferritin-induced IL-1β expression was inhibited by 70±7.5% (Figure 7E), implicating both MEK1/2 and MAP-kinase in ferritin-induced signalling.
Figure 7. MAP kinase (p42/p44) is phosphorylated by ferritin in activated rat HSC.



Day 5 culture-activated HSC were incubated with either increasing concentrations of ferritin (10 pM - 100nM) for 1 hour (A, B), or 10nM ferritin for 0-240 minutes (C, D). Reactions were terminated and whole cell protein extracted and subsequently subjected to western blotting to identify changes in the phosphorylation status of p42/p44. Both p42 and p44 were significantly phosphorylated in a dose-dependent manner (ANOVA; P<0.0001 and P<0.0001, respectively B), with peak phosphorylation occurring at between 10 and 100nM. In addition both p42 and p44 were significantly phosphorylated in a time-dependent manner (ANOVA; P=0.0447 and P=0.0016, respectively D), with peak phosphorylation occurring between 60-120 minutes. U0126, an inhibitor of MAP/ERK kinase (MEK)-1/2, was used to inhibit potential signalling via MAPK phosphorylation. Day 5 culture-activated HSC were preincubated with 10μM U0126 for 30 minutes before incubation with 10nM ferritin in the continued presence of U0126. U0126 significantly inhibited the ferritin-induced expression of IL-1β mRNA, implicating a role for MEK1/2 and MAPK in the signalling pathway induced by ferritin (E). ⋆⋆ and ⋆⋆⋆ indicates a significant difference from control untreated HSC (P < 0.01) or indicated mean values. Data is expressed as mean value of three separate experiments performed in duplicate ± SEM.
Ferritin induces NFκB activation and IL-1β expression via an iron-independent pathway
As tissue ferritin stores iron it is possible that the NFκB-transcriptional events elicited by ferritin may be, in part, due to iron-induced oxidant stress. We used de-ironed ferritin (apoferritin) and iron-free rHF and rLF to assess their effect on NFκB DNA-binding activity and IL-1β gene transcription. Treatment of activated HSC with apoferritin, rHF or rLF caused a significant increase in NFκB DNA-binding activity (Figure 8A). rHF and rLF also induced a significant time-dependent increase in IL-1β expression (Figure 8B). rHF induced a 221.7±51.2 fold increase in IL-1β; significantly greater than rLF (69.9±17.7 fold) (Figure 8B). In addition, iron chelators of both Fe2+ (Dipyridyl) and Fe3+ (Deferoxamine) were used to block the potential effects of iron contained within tissue ferritin. Neither Dipyridyl (Figure 8C) nor Deferoxamine (Figure 8D) had any effect on IL-1β gene expression induced by ferritin. Taken together, these data provide further evidence of a ferritin-induced signalling pathway resulting in NFκB-regulated gene expression that is independent of iron.
Figure 8. Iron does not mediate the effects of ferritin on activated rat HSC.


Day 5 culture-activated HSC were incubated with 10nM apoferritin, iron-free recombinant H-ferritin (rHF) or iron-free recombinant L-ferritin (rLF) for 0-2 hours. Nuclear extracts were then harvested and assessed for NFκB DNA-binding activity using EMSA, with densitometric analysis of EMSA blots analysed and quantitated (A). All three iron-free ferritin molecules induced significant NFκB DNA-binding activity in a time-dependent manner (ANOVA: P=0.0112, apoferritin; P=0.0017, rHF and P=0.0242, rLF) with rHF inducing the most rapid and significant changes in NFκB activity. To determine the effects of iron-free 10nM rHF or rLF on day 5 activated HSC, cells were incubated with either rHF or rLF for 0-4 hours before total RNA was isolated and analysed for changes in IL-1β gene transcription using quantitative PCR (B). Both rHF and rLF caused a significant elevation in IL-1β mRNA expression in a time-dependent manner (ANOVA, P=0.05 and P=0.028, respectively), with the effect of rHF being significantly greater than that of rLF at 2 hours. To further test the role of iron in ferritin induced gene expression, day 5 culture-activated HSC were incubated with the Fe2+ chelating agent Dipyridyl (DP, 250 μM; C) or the Fe3+ chelating agent Deferoxamine (DFO, 200 μM; D) for 1 hour prior to treatment with 10nM ferritin for 3 hours in the continued presence of either DP or DFO. Total RNA was harvested and analysed for the expression of IL-1β using quantitative PCR. The chelation of iron by either DP or DFO had no influence on the ferritin-induced transcription of the IL-1β gene. ⋆ and ⋆⋆⋆ indicate a significant difference of the indicated mean values or from control untreated samples (P<0.05 and P<0.0001). Data is expressed as mean value of three separate experiments performed in duplicate ± SEM.
Discussion
The association between inflammation and raised circulating ferritin in chronic liver injury is well established, however, rather than simply being a consequence of inflammation, elevated ferritin levels may play a role in mediating the processes associated with hepatic injury. This study is the first to demonstrate the potential role of ferritin as a cytokine-like signaling molecule in the liver rather than a passive indictor of iron stores or inflammation. L chain-rich tissue ferritin, recombinant H-chain ferritin and recombinant L-chain ferritin all initiated the activation of a signaling pathway in rat HSC, independent of iron, involving PI3-kinase, PKCζ, MEK1/2, MAP-kinase, IKKα/β and NFκB, within minutes resulting in the upregulation of proinflammatory mediators associated with HSC activation and hepatic fibrogenesis (Figure 9). While this study did not directly assess the role of serum ferritin in HSC activation, serum ferritin is comprised of glycosylated L-ferritin, and our data show a clear role for L-ferritin as a proinflammatory mediator in HSC biology. While this suggests serum ferritin may have similar effects as tissue-derived L-ferritin, further investigation is required to assess the role of serum ferritin on this signalling pathway.
Figure 9. Proposed hypothetical ferritin-induced signalling pathway in activated HSC.

Φερριτιν βινδσ το υνκνοων ρεχεπτορ εξπρεσσεδ βψ αχτιϖατεδ ρατ HΣX ανδ ρτιμ υλατεσ α σιγναλλινγ χασχαδε τηατ ρεσυλτσ ιν τηε αχτιϖατιον οϕ NΦκB and subsequently enhances the expression of a number of NFκB-responsive genes including, IL-1β, IκBα, ICAM1, RANTES and iNOS. Data presented in this study implicates PI3-kinase, PCKζ, MEK1/2, MAPK and IKKα/β in this signalling cascade. The observed upregulation in gene expression and phosphorylation of the signalling intermediates occurs independently of iron. Dotted arrows indicate the hypothesized sequence of signalling events. IKK, inhibitor kappa B kinase α/β; MAPK, mitogen activated protein kinase; MEK1/2, MAPK ERK kinase 1/2; PI3K, phosphatidylinositol 3 kinase; PKCζ, protein kinase C ζ.
While the precise mechanisms of ferritin release and the functions of secreted ferritins in the circulation are unclear, tissue ferritin is known to be released from reticuloendothelial cells following erythrophagocytosis of senescent red blood cells (26). Ferritin is present in the circulation either via secretion in the form of serum ferritin or through release from damaged cells in the form of tissue ferritin (27). In the liver, ferritin released by damaged hepatocytes or Kupffer cells is thought to contribute considerably to the local ferritin concentration (27) and may have a direct paracrine effect on cells in close proximity. In iron overload diseases such as hereditary hemochromatosis circulating ferritin levels are substantially elevated and can range in concentration from 200-6500 µg/L (0.5-15nM) (28). Circulating ferritins are also elevated independently of iron overload in conditions of inflammation, alcohol abuse, liver necrosis, or in patients with NASH or diabetes mellitus (29-31). Indeed, ferritin may play a role in an array of inflammatory/fibrogenic states associated with infection in organs such as the heart, lungs, kidney and pancreas, all of which have cell types similar to HSC that mediate the fibrogenic response to injury (2, 3).
Activated rat HSC were used as a model to investigate the role of ferritin as a mediator of inflammation as they express a specific binding site for ferritin (7), and play a key role in the livers response to injury (6). To test the hypothesis that ferritin exhibits cytokine-like activity we selected NFκB as its potential mediator as it is a common target for proinflammatory factors and is known to regulate both HSC survival and the expression of proinflammatory factors associated with fibrogenesis (15, 16, 32). In this study we have shown that ferritin induces the activation of NFκB in HSC via PI3 kinase, PKCζ, MEK1/2, MAPK and IKK leading to the enhanced transcription of the NFκB-responsive genes ICAM1, IκBa, iNOS, RANTES and IL-1β. The rapid induction of these genes suggest the direct effect of ferritin on a second messenger system. Considerable elevations in iNOS, RANTES and IL-1β were observed (>40fold) and all have a well documented role in inflammation and fibrosis (19, 33, 34). Their induction by ferritin lends considerable support to the hypothesis that ferritin acts as a proinflammatory mediator. Quiescent HSC were also assessed for their ability to respond to ferritin, however, no effects were observed on IκBa, RANTES, or ICAM1, with only a small 2.5-fold increase seen in IL-1b expression using 100nM ferritin. These findings support earlier studies suggesting that quiescent HSC do not express a specific receptor for ferritin (7, 8) and also add considerable weight to our hypothesis that ferritin induces a specific receptor-mediated signalling event in activated HSC. To further substantiate these observations we used a well characterised inhibitor of cytokine-induced IκBa phosphorylation, Bay11-7082 (20, 35). This compound completely blocked the ferritin-induced expression of the NFκB-responsive gene IL-1β. Taken together these results provide strong evidence that tissue ferritin activates NFκB and the inhibitory effects of Bay11-7082 suggest that the effects of ferritin may be cytokine-like rather than due to ferritin-bound iron. ICAM1 protein expression and Nitric Oxide production were also significantly elevated in rat HSC treated with ferritin suggesting that the transcriptional changes observed result in actual changes in cellular protein. The degree of iNOS gene expression induction would suggest that greater production of nitric oxide might have been expected. This inconsistency may in part be due to the potential instability of the iNOS mRNA or rapid iNOS protein turnover.
The identity of the HSC ferritin receptor is unknown. Tim-2 has been proposed as a cell surface receptor for H-ferritin endocytosis in recent studies using B cells (21). Two additional proteins, H-Kininogen (36) and the G-CSF receptor (37), have both been shown to interact with H-ferritin in different cell systems, although the functional consequences are unclear. As previous studies have shown H-ferritin-dependent binding of tissue ferritin to activated HSC, followed by internalisation (7), it is possible Tim-2 may play a role in the ferritin-induced changes observed in activated HSC. Tim-2 expression was demonstrated in quiescent HSC with expression unchanged during HSC activation. The observation that Tim-2 is expressed in quiescent HSC and our observation that quiescent HSC don't respond to ferritin suggests that Tim-2 may not be responsible for mediating the effects of ferritin on HSC. Contained within the intracellular amino acid sequence of Tim-2 are potential tyrosine kinase and PI3-kinase target sites thought to mediate the intracellular signaling of another Tim-2 ligand, Semaphorin 4A (38). Thus, we investigated the potential for PI3-kinase to mediate the effects of ferritin, iron-free rHF and rLF. Ferritin induced the phosphorylation of the tyrosine amino acid in the consensus PI3-kinase target motif YXXM. However, when all YXXM phospho-proteins were immunoprecipitated, no ferritin molecule had any effect on Tim-2 protein YXXM phosphorylation. While this does not discount a role for Tim-2 in mediating the effects of ferritin, it suggests that it is not through phosphorylation of the Tim-2 YXXM motif by PI3-kinase. In addition, the steady state expression of Tim-2 protein is at odds with earlier observations which suggest that the ferritin receptor is only present on activated, not quiescent HSC (7) and that ferritin receptor expression increases with culture-activation (8). This fact, coupled with our observation that Tim-2-expressing quiescent HSC do not respond to ferritin, suggest that Tim-2 is not responsible for eliciting the ferritin-induced signalling events demonstrated in this study. Tim-2 may indeed represent the “scavenger ferritin receptor” described by Moss et al. (39), and thus it is likely that activated HSC express another, as yet unidentified ferritin receptor.
As the target motif of PI3-kinase was phosphorylated in response to ferritin, we investigated the role of PI3-kinase in ferritin-induced signaling by using the inhibitor wortmannin (22). Wortmannin inhibited ferritin-induced IL-1β transcription by approximately 80%, but even at the highest concentration was unable to completely abolish IL-1β expression. Thus, ferritin appears to function in activated HSC via PI3-kinase, although a non PI3-kinase ferritin-dependent pathway (possibly tyrosine kinase-dependent) may also exist.
The results of this study also implicate the signaling intermediate PKCζ in the ferritin-induced signaling cascade. Our data demonstrated a rapid, time-dependent increase in PKCζ phosphorylation by ferritin and the induction of IL-1β transcription by ferritin was highly sensitive to the pseudosubstrate inhibitor of PKCζ. Long term (7 days) incubation of HSC with ferritin resulted in marked down-regulation of PKCζ expression, an event that was exquisitely sensitive to ferritin with significant decreases noted with 10pM ferritin. PKCζ is an atypical PKC and is known to be crucial for cell survival. It is also often constitutively active and has been shown to be an upstream regulator of NFβB activity (23). Chronic (long-term) activation of PKC is known to lead to the depletion of cellular levels of PKC in other cell types via a desensitisation mechanism (24). Taken together, these results suggest that PKCζ plays an integral role in ferririn-induced signaling and indeed that ferritin acts as a PKC-ζ activator in HSC biology.
This study also demonstrated that ferritin activated another downstream signaling target, MAP-kinase (p42/p44). As previously mentioned MAP-kinase is a known target of PKCζ and has been shown to regulate IKK phosphorylation and the activity of NFκB (25). Our results clearly show that tissue ferritin induced the rapid phosphorylation of MAP-kinase in a time- and dose-dependent manner similar to that observed for IKKα/β, PI3-kinase and PKCζ. We were also able to demonstrate the susceptibility of ferritin induced IL-1β expression to the MEK1/2 (and hence MAP-kinase) inhibitor U0126. The ability of ferritin to induce these changes in such a rapid manner, lends further support to the proposal that ferritin exhibits cytokine-like activity mediated by a receptor coupled to a signaling cascade.
As we have proposed that ferritin influences proinflammatory events in the HSC activation cascade via cytokine-like signal transduction, it was important to rule out the potential role of ferritin-bound iron. Iron is a potent mediator of oxidant stress (40) with reactive oxygen species known to play a role in NFκB activation (9). Iron-free ferritin molecules rHF, rLF (a serum ferritin analogue) and apoferritin were all shown to induce the time-dependent activation of NFκB, and both rHF and rLF caused marked upregulation of IL-1β gene expression. Interestingly, rHF was considerably more effective possibly due to the expression of a known H-chain dependent binding site on activated HSC (7). In addition, these iron-free ferritin molecules activated IKKα/β, PI3-kinase, and MAP-kinase (results not shown). As further evidence of an iron-independent ferritin signalling pathway, neither iron chelator DFO (Fe3+) nor DP (Fe2+) had any inhibitory effect on ferritin-induced IL-1β transcription. These chelators block cellular uptake of iron (bound to transferrin) and endosomal release, respectively (41). Thus, use of these chelating agents removes all available unbound cellular iron, preventing the potential generation of oxidant stress, thus ruling out iron as a mediator of ferritin-induced signalling in HSC.
In conclusion, previous studies have shown a role for ferritin in mediating immune function, haematopoiesis, hepatocyte apoptosis and cell differentiation but no studies have defined the potential mechanism. Our study is the first to provide strong evidence that ferritin exhibits iron-independent, cytokine-like activity in activated HSC inducing a signaling cascade which upregulates expression of proinflammatory mediators associated with hepatic fibrogenesis. While this study has demonstrated the expression of an H-ferritin endocytotic receptor, Tim-2, its role as a potential mediator of ferritin-induced HSC signalling is unclear. The role of ferritin as a modulator of hepatic/extrahepatic inflammation warrants further investigation.
Financial Support
This work was supported by research grants from the National Institutes of Health (Grant No. RO1DK57648-01 to GAR) and the National Health and Medical Research Council (NHMRC) of Australia (Grant No. 339400 to GAR). Associate Professor Grant A. Ramm is supported by a Senior Research Fellowship from the NHMRC of Australia (Grant No. 241913).
Abbreviations
- HSC
hepatic stellate cell
- αSMA
α-smooth muscle action
- Tim-2
T cell immunoglobulin-domain and mucin-domain 2
- rHF
recombinant human H-ferritin
- rHL
recombinant human L-ferritin
Footnotes
Disclosure: The authors have no financial conflicts to disclose.
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