Iron uptake at the blood-brain barrier is influenced by sex and genotype.

Iron transport to the brain is a critically important and highly regulated process necessary for proper brain function. This review aims to summarize iron uptake mechanisms in the brain and the importance of sex and genotype on this uptake. In restless legs syndrome (RLS), brain iron uptake has been hypothesized to be dysregulated, leading to the clinically observed brain iron deficiency, so this review specifically comments on this disorder. The review covers transferrin-bound transport and the more recently discovered role of ferritin in brain iron delivery. Studies on the impact of sex, MEIS1 (associated with RLS), and H63D gene variants have revealed critical regulatory mechanisms and driving factors that significantly impact iron transport that may considerably affect the clinical treatment of RLS. RLS has provided insights into the gaps in knowledge underlying brain iron uptake mechanisms and their regulation, which in turn have provided insights into the pathophysiology of RLS.