Deferiprone for the treatment of Friedreich's ataxia

Authors


Address correspondence and reprint requests to Massimo Pandolfo, ULB-Hôpital Erasme, Route de Lennik 808, 1070 Brussels, Belgium. E-mail: massimo.pandolfo@ulb.ac.be

Abstract

Friedreich's ataxia (FRDA) is a neurological disease related to a deficiency of the protein frataxin involved in iron–sulfur (Fe–S) cluster biogenesis. This leads to an increased cellular iron uptake accumulating in mitochondria, and a subsequently disturbed iron homeostasis. The detailed mechanism of iron regulation of frataxin expression is yet unknown. Deferiprone, an iron chelator that may cross the blood–brain barrier, was shown to shuttle iron between subcellular compartments. It could also transfer iron from iron-overloaded cells to extracellular apotransferrin and pre-erythroid cells for heme synthesis. Here, clinical studies on Deferiprone are reviewed in the context of alternative agents such as desferoxamine, with specific regard to its mechanistic and clinical implications.

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