Elevated TFR1 is associated with inflammatory burden and ferroptosis in ulcerative colitis.

Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by mucosal inflammation, oxidative stress, and iron metabolism dysregulation. Ferroptosis, an iron-dependent form of regulated cell death, may contribute to the pathogenesis of UC. Transferrin receptor 1 (TFR1), a key mediator of cellular iron uptake, links iron dysregulation to inflammation and ferroptosis; however, its clinical relevance in UC is not well defined. Methods: Serum samples were collected from 83 patients with active UC and 80 age- and sex-matched healthy controls. Disease activity was assessed using the modified Mayo score. Serum TFR1, inflammatory cytokine, coagulation indices, oxidative stress marker, and ferroptosis-related antioxidant levels were measured. Correlations and receiver operating characteristic (ROC) curve analyses were performed to evaluate the associations and diagnostic performance. Results: Serum TFR1 levels were significantly higher in patients with UC than in controls ( Conclusion: Elevated serum TFR1 levels are associated with UC severity, systemic inflammation, oxidative stress, and ferroptosis-related imbalance. These findings suggest that TFR1 is a potential biomarker for UC activity and highlight iron-driven ferroptosis as a promising therapeutic target, providing novel clinical insights into disease monitoring and management.