Transferrin receptor (TfR)

The transferrin receptor (TfR) is the gateway for transferrin-bound-iron entering all body cells. TfR is abundant on the surface of many newly formed cells, but the erythroid marrow cells account for 70 to 80 % of the total body TfR content. The soluble (or serum) transferrin receptor (sTfR) is a circulating truncated form of the membrane receptor protein; it is an 85 kDa glycoprotein forming in serum a 320 kDa complex with diferric transferrin. The serum sTfR concentration reflects the total body mass of cellular transferrin receptor. Anaemias associated with enhanced erythropoiesis and iron deficiency result in an elevation in the sTfR values. The normal sTfR concentrations are about 1.0 – 2.9 μg/ml for adults, when using this assay, the iron deficiency may increase the values up to 20 fold (various normal values have been established by other producers for their assays). Elevation of the soluble transferrin receptor may be also caused by haemolytic anaemia, polycythaemia and thalassemia while aplastic anaemia and chronic renal failure may result in decrease. The most important clinical use of the sTfR determination is in the differential diagnosis between iron deficiency anaemia and the anaemia of chronic disease.