Metal metabolism and liver

Abstract

The liver is the central organ for the metabolism of iron and copper. Therefore, primary metabolic disorders of iron and copper give rise to liver diseases, and secondary iron and copper disorders induced by chronic liver diseases potentially modify or aggravate the clinical courses of the original liver diseases. This chapter will review and discuss (1) iron and copper metabolism, (2) hemochromatosis and Wilson disease as primary iron and copper metabolic disorders, and (3) mechanisms underlying secondary iron metabolic disorders induced by chronic liver diseases such as chronic hepatitis C and nonalcoholic fatty liver disease (NAFLD). The degree of hepatic iron accumulation in chronic hepatitis C and NAFLD is not as severe as that in hereditary hemochromatosis. However, mild to moderate hepatic iron accumulation potentially modifies the disease progression and induces the development of hepatocellular carcinoma (HCC) in chronic hepatitis C and NAFLD. Abnormal metabolism of copper in the liver is detected in patients with Wilson disease. This is a peculiar disease, because it is a rare genetic metabolic disorder that can be treated by pharmacological treatments. However, prompt recognition, diagnosis, and adequate treatment are essential, because inadequate management is fatal for the patients.