Iron Biology Unveiled: Hepcidin, Erythroferrone and the Modern Understanding of Iron Metabolism – A dialogue between Robin Foà, Filippo Milano e Clara Camaschella

In this episode, Prof. Robin Foà and Dr. Filippo Milano are joined by Dr. Clara Camaschella to explore the evolution of iron metabolism, tracing one of the most elegant and coherent stories in modern hematology. From the early conceptual models of iron regulation to the molecular breakthroughs that defined the field, the discussion reflects on what has been described as a true “golden age” of iron biology.The conversation revisits the fundamental principles of iron homeostasis, highlighting the central role of recycling over absorption and the absence of a regulated excretory pathway—features that make systemic control both essential and uniquely complex. From the pioneering work of Clement Finch to the discovery of HFE and the unraveling of genetic heterogeneity, the speakers guide listeners through the key milestones that shaped current understanding.At the heart of the episode is the discovery of hepcidin, the master regulator of iron metabolism, and the mechanisms that govern its interaction with ferroportin. The dialogue also explores the role of erythroferrone in linking erythropoiesis to iron availability, providing a molecular explanation for long-standing physiological hypotheses and shedding light on conditions such as thalassemia.Despite these advances, therapeutic strategies remain rooted in traditional approaches such as phlebotomy, raising important questions about the translation of molecular insights into clinical practice. Looking ahead, the discussion expands toward emerging fields including ferroptosis, immunity, and the role of iron in cardiovascular biology.A rich and reflective journey through discovery, this episode captures both the clarity and the complexity of iron metabolism—an essential system where biology, genetics, and clinical medicine converge.