Targeting macrophage ferritin heavy chain mitigates ferroptosis and lung injury in experimental acute respiratory distress syndrome

W William Z. Zhang K Kihwan Kim D Divya Bhatia L Lynne Faherty W Will Simmons E Eleni Kallinos S Sebastian E. Carrasco K Katherine L. Hoffman S Sean Houghton C Chia-Lang Hsu L Leora Haber C Cem Meydan (Department of Physiology and Biophysics, Weill Cornell Medicine) C Christopher E. Mason A Ananda S. Mirchandani S Sarah R. Walmsley P Parag Goyal K Kuei-Pin Chung K Karla V. Ballman (From the Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda (A.B.A., N.S., S.N., L.L., L.C.), the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore (J.H.-C.), and the Investigational Drug Branch, Cancer Therapy Evaluation Program, National Cancer Institute, National Institutes of Health, Rockville (H.S., E.S.) — all in Maryland; the Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN (K.V.B., M.O., C.M., G.P.B.); AdventHealth Cancer Institute and the University of Central Florida, Orlando (G.S.); Dana–Farber/Harvard Cancer Center, Boston (S.B., B.M.); UNC Lineberger Comprehensive Cancer Center, Chapel Hill (W.Y.K.), and Duke University Medical Center and Duke Cancer Institute, Durham (J.H., S.H.) — both in North Carolina; the University of Kansas Cancer Center, Westwood (R.P.); Memorial Sloan Kettering Cancer Center, New York (M.Y.T., M.J.M., J.E.R.), and Roswell Park Comprehensive Cancer Center, Buffalo (G.C.) — both in...) D David Redmond J Joseph D. Mancias A Augustine M. K. Choi E Edward J. Schenck (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Weill Cornell Medicine) M Maria Plataki S Suzanne M. Cloonan

Abstract

Abstract Ferritin, composed of heavy chain (FTH1) and light chain (FTL) subunits, is a key intracellular iron storage protein, but the origin and biological role of extracellular ferritin (ex-ferritin) remain poorly understood. Elevated serum ex-ferritin is associated with worse outcomes in acute respiratory distress syndrome (ARDS). Here, we show that both FTH1 and FTL are significantly enriched in the serum, blood monocytes, and alveolar macrophages (AM) of individuals with ARDS, findings we replicate in a murine hyperoxia-induced acute lung injury model. Myeloid-specific FTH1 ( Fth1 ΔLysM ) deletion attenuates lung injury, and is associated with reduced macrophage ferroptosis, altered airway inflammatory responses, lower extracellular iron and compensatory secretion of FTL-ex-ferritin. While pharmacologic ferroptosis inhibition prior to hyperoxia had no effect, transplantation of FTL-ex-ferritin-enriched bronchoalveolar lavage fluid conferred protection from lung injury. These findings identify macrophage ferritin metabolism and ex-ferritin secretion as critical regulators of lung injury, offering new insights into the pathobiology of ARDS.

Article Details

Volume / Issue Vol. 1, Issue 1
Published June 27, 2026
ISSN 2041-1723
Publisher Nature Portfolio

Journal Info

Nature Communications

Nature Portfolio

ISSN: 2041-1723 Open Access Life Sciences

Authors (24)

W

William Z. Zhang

K

Kihwan Kim

D

Divya Bhatia

L

Lynne Faherty

W

Will Simmons

E

Eleni Kallinos

S

Sebastian E. Carrasco

K

Katherine L. Hoffman

S

Sean Houghton

C

Chia-Lang Hsu

L

Leora Haber

C

Cem Meydan

Department of Physiology and Biophysics, Weill Cornell Medicine

C

Christopher E. Mason

A

Ananda S. Mirchandani

S

Sarah R. Walmsley

P

Parag Goyal

K

Kuei-Pin Chung

K

Karla V. Ballman

From the Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda (A.B.A., N.S., S.N., L.L., L.C.), the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore (J.H.-C.), and the Investigational Drug Branch, Cancer Therapy Evaluation Program, National Cancer Institute, National Institutes of Health, Rockville (H.S., E.S.) — all in Maryland; the Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN (K.V.B., M.O., C.M., G.P.B.); AdventHealth Cancer Institute and the University of Central Florida, Orlando (G.S.); Dana–Farber/Harvard Cancer Center, Boston (S.B., B.M.); UNC Lineberger Comprehensive Cancer Center, Chapel Hill (W.Y.K.), and Duke University Medical Center and Duke Cancer Institute, Durham (J.H., S.H.) — both in North Carolina; the University of Kansas Cancer Center, Westwood (R.P.); Memorial Sloan Kettering Cancer Center, New York (M.Y.T., M.J.M., J.E.R.), and Roswell Park Comprehensive Cancer Center, Buffalo (G.C.) — both in...

D

David Redmond

J

Joseph D. Mancias

A

Augustine M. K. Choi

E

Edward J. Schenck

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Weill Cornell Medicine

M

Maria Plataki

S

Suzanne M. Cloonan