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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Micronutrients and Human Health".

Deadline for manuscript submissions: closed (20 July 2023) | Viewed by 43926

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Special Issue Editor

Dr. Dietmar Enko

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Guest Editor

Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, A-8036 Graz, Austria
Interests: food intolerance (lactose, fructose, sorbitol, histamine); iron deficiency; carbohydrate metabolism; hematology/hemostaseologie
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Special Issue Information

Dear Colleagues,

The goal of this Special Issue, “Physiology and Pathophysiology of Iron Metabolism”, is to focus on the importance of the micronutrients iron in human physiological iron homeostasis and iron-related diseases. Daily adequate dietary iron supply ensures vital body functions and hemoglobin synthesis during the erythropoiesis. During the last few decades, scientific evidence has shown that the maintenance of the human iron homeostasis is an important factor for physical and mental health.

Specifically, the aim of this Special Issue is to give an overview of how iron, as an essential dietary element, is responsible for physiological and pathological biochemical processes in the human body.

This actual information will provide an evidence-based update on the complex regulatory mechanisms and related diseases of iron metabolism for the readership of this journal.

Dr. Dietmar Enko
Guest Editor

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Keywords

iron
iron metabolism
iron regulator proteins
intestinal iron resorption
body iron stores
iron deficiency
nutritional factors of iron homeostasis
iron overload disorders
hereditary disorders of iron metabolism

Published Papers (13 papers)

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Research

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20 pages, 3489 KiB

Open AccessArticle

Nitrosative and Oxidative Stress, Reduced Antioxidant Capacity, and Fiber Type Switch in Iron-Deficient COPD Patients: Analysis of Muscle and Systemic Compartments

by Maria Pérez-Peiró, Mariela Alvarado Miranda, Clara Martín-Ontiyuelo, Diego A. Rodríguez-Chiaradía and Esther Barreiro

Nutrients 2023, 15(6), 1454; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15061454 - 17 Mar 2023

Viewed by 1343

Abstract

We hypothesized that a rise in the levels of oxidative/nitrosative stress markers and a decline in antioxidants might take place in systemic and muscle compartments of chronic obstructive pulmonary disease (COPD) patients with non-anemic iron deficiency. In COPD patients with/without iron depletion (n = 20/group), markers of oxidative/nitrosative stress and antioxidants were determined in blood and vastus lateralis (biopsies, muscle fiber phenotype). Iron metabolism, exercise, and limb muscle strength were assessed in all patients. In iron-deficient COPD compared to non-iron deficient patients, oxidative (lipofuscin) and nitrosative stress levels were greater in muscle and blood compartments and proportions of fast-twitch fibers, whereas levels of mitochondrial superoxide dismutase (SOD) and Trolox equivalent antioxidant capacity (TEAC) decreased. In severe COPD, nitrosative stress and reduced antioxidant capacity were demonstrated in vastus lateralis and systemic compartments of iron-deficient patients. The slow- to fast-twitch muscle fiber switch towards a less resistant phenotype was significantly more prominent in muscles of these patients. Iron deficiency is associated with a specific pattern of nitrosative and oxidative stress and reduced antioxidant capacity in severe COPD irrespective of quadriceps muscle function. In clinical settings, parameters of iron metabolism and content should be routinely quantify given its implications in redox balance and exercise tolerance. Full article

(This article belongs to the Special Issue Physiology and Pathophysiology of Iron Metabolism)

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9 pages, 273 KiB

Open AccessCommunication

Hepcidin Status in Cord Blood: Observational Data from a Tertiary Institution in Belgium

by Michael Ceulemans, Joline Van de Vel, Dorine W. Swinkels, Coby M. M. Laarakkers, Jaak Billen, Kristel Van Calsteren and Karel Allegaert

Nutrients 2023, 15(3), 546; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15030546 - 20 Jan 2023

Cited by 2 | Viewed by 1471

Abstract

The hormone hepcidin plays an important role in intestinal iron absorption and cellular release. Cord blood hepcidin values reflect fetal hepcidin status, at least at the time of delivery, but are not available for the Belgian population. Therefore, we aimed (1) to provide the first data on cord blood hepcidin levels in a Belgian cohort and (2) to determine variables associated with cord blood hepcidin concentrations. A cross-sectional, observational study was performed at the University Hospital Leuven, Belgium. Cord blood samples were analyzed using a combination of weak cation exchange chromatography and time-of-flight mass spectrometry. Descriptive statistics, Spearman correlation tests, and Mann–Whitney U tests were performed. In total, 61 nonhemolyzed cord blood samples were analyzed. The median hepcidin level was 17.6 μg/L (IQR: 18.1; min-max: 3.9–54.7). A moderate correlation was observed between cord blood hepcidin and cord blood ferritin (r = 0.493) and hemoglobin (r = −0.342). Cord blood hepcidin was also associated with mode of delivery (p = 0.01), with higher hepcidin levels for vaginal deliveries. Nonetheless, larger studies are needed to provide more evidence on the actual clinical value and benefit of cord blood hepcidin measurements. Full article

(This article belongs to the Special Issue Physiology and Pathophysiology of Iron Metabolism)

11 pages, 659 KiB

Open AccessArticle

Effect of Ferric Carboxymaltose Supplementation in Patients with Heart Failure with Preserved Ejection Fraction: Role of Attenuated Oxidative Stress and Improved Endothelial Function

by Annachiara Mollace, Roberta Macrì, Rocco Mollace, Annamaria Tavernese, Micaela Gliozzi, Vincenzo Musolino, Cristina Carresi, Jessica Maiuolo, Martina Nicita, Rosamaria Caminiti, Sara Paone, Francesco Barillà, Maurizio Volterrani and Vincenzo Mollace

Nutrients 2022, 14(23), 5057; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14235057 - 28 Nov 2022

Cited by 10 | Viewed by 2859

Abstract

Both clinical and experimental evidence shows that iron deficiency (ID) correlates with an increased incidence of heart failure (HF). Moreover, data on iron supplementation demonstrating a beneficial effect in subjects with HF have mostly been collected in patients undergoing HF with reduced ejection fraction (HFrEF). Relatively poor data, however, exist on the potential of iron supplementation in patients with HF with preserved ejection fraction (HFpEF). Here, we report on data emerging from a multicentric, double-blind, randomized, placebo-controlled study investigating the effect of IV supplementation with a placebo or ferric carboxymaltose (FCM) on 64 subjects with HFpEF. ID was detected by the measurement of ferritin levels. These data were correlated with cardiac performance measurements derived from a 6 min walking test (6MWT) and with echocardiographic determinations of diastolic function. Moreover, an EndoPAT analysis was performed to correlate cardiac functionality with endothelial dysfunction. Finally, the determination of serum malondialdehyde (MDA) was performed to study oxidative stress biomarkers. These measurements were carried out before and 8 weeks after starting treatment with a placebo (100 mL of saline given i.v. in 10 min; n = 32) or FCM at a dose of 500 mg IV infusion (n = 32), which was given at time 0 and repeated after 4 weeks. Our data showed that a condition of ID was more frequently associated with impaired diastolic function, worse 6MWT and endothelial dysfunction, an effect that was accompanied by elevated MDA serum levels. Treatment with FCM, compared to the placebo, improved ferritin levels being associated with an improved 6MWT, enhanced cardiac diastolic function and endothelial reactivity associated with a significant reduction in MDA levels. In conclusion, this study confirmed that ID is a frequent comorbidity in patients with HFpEF and is associated with reduced exercise capacity and oxidative stress-related endothelial dysfunction. Supplementation with FCM determines a significant improvement in diastolic function and the exercise capacity of patients with HFpEF and is associated with an enhanced endothelial function and a reduced production of oxygen radical species. Full article

(This article belongs to the Special Issue Physiology and Pathophysiology of Iron Metabolism)

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20 pages, 3046 KiB

Open AccessArticle

Positive or U-Shaped Association of Elevated Hemoglobin Concentration Levels with Metabolic Syndrome and Metabolic Components: Findings from Taiwan Biobank and UK Biobank

by Vanessa Joy Timoteo, Kuang-Mao Chiang and Wen-Harn Pan

Nutrients 2022, 14(19), 4007; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14194007 - 27 Sep 2022

Cited by 5 | Viewed by 1979

Abstract

Iron overnutrition has been implicated with a higher risk of developing metabolic and cardiovascular diseases, including metabolic syndrome (MetS), whereas iron deficiency anemia exacerbates many underlying chronic conditions. Hemoglobin (Hb) concentration in the blood, which reflects a major functional iron (i.e., heme iron) in the body, may serve as a surrogate of the nutritional status of iron. We conducted sex-specific observational association studies in which we carefully titrated the association between Hb deciles and MetS and its components among the Taiwanese Han Chinese (HC) from the Taiwan Biobank and Europeans of White ancestry from the UK Biobank, representing two large ethnicities. Our data show that at higher-than-normal levels of Hb, increasing deciles of Hb concentration were significantly associated with MetS across all sex subgroups in both ethnicities, with the highest deciles resulting in up to three times greater risk than the reference group [Taiwanese HC: OR = 3.17 (95% CI, 2.75–3.67) for Hb ≥ 16.5 g/dL in men, OR = 3.11 (2.78–3.47) for Hb ≥ 14.5 g/dL in women; European Whites: OR = 1.89 (1.80–1.98) for Hb ≥ 16.24 g/dL in men, OR = 2.35 (2.24–2.47) for Hb ≥ 14.68 g/dL in women]. The association between stronger risks and increasing Hb deciles was similarly observed with all metabolic components except diabetes. Here we found that both the highest Hb decile groups and contrarily the lowest ones, with respect to the reference, were associated with higher odds of diabetes in both ethnic groups [e.g., Taiwanese HC men: OR = 1.64 (1.33–2.02) for Hb ≥ 16.5 g/dL, OR = 1.71 (1.39–2.10) for Hb ≤ 13.5 g/dL; European Whites women: OR = 1.39 (1.26–1.45) for Hb ≥ 14.68 g/dL, OR = 1.81 (1.63–2.01) for Hb ≤ 12.39 g/dL]. These findings confirm that elevated Hb concentrations, a potential indicator of iron overnutrition, may play a role in the pathophysiology of MetS and metabolic components. Full article

(This article belongs to the Special Issue Physiology and Pathophysiology of Iron Metabolism)

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21 pages, 4491 KiB

Open AccessArticle

Iron Depletion in Systemic and Muscle Compartments Defines a Specific Phenotype of Severe COPD in Female and Male Patients: Implications in Exercise Tolerance

by Maria Pérez-Peiró, Mariela Alvarado, Clara Martín-Ontiyuelo, Xavier Duran, Diego A. Rodríguez-Chiaradía and Esther Barreiro

Nutrients 2022, 14(19), 3929; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14193929 - 22 Sep 2022

Cited by 5 | Viewed by 1919

Abstract

We hypothesized that iron content and regulatory factors, which may be involved in exercise tolerance, are differentially expressed in systemic and muscle compartments in iron deficient severe chronic obstructive pulmonary disease (COPD) patients. In the vastus lateralis and blood of severe COPD patients with/without iron depletion, iron content and regulators, exercise capacity, and muscle function were evaluated in 40 severe COPD patients: non-iron deficiency (NID) and iron deficiency (ID) (20 patients/group). In ID compared to NID patients, exercise capacity, muscle iron and ferritin content, serum transferrin saturation, hepcidin-25, and hemojuvelin decreased, while serum transferrin and soluble transferrin receptor and muscle IRP-1 and IRP-2 increased. Among all COPD, a significant positive correlation was detected between FEV₁ and serum transferrin saturation. In ID patients, significant positive correlations were detected between serum ferritin, hepcidin, and muscle iron content and exercise tolerance and between muscle IRP-2 and serum ferritin and hepcidin levels. In ID severe COPD patients, iron content and its regulators are differentially expressed. A potential crosstalk between systemic and muscle compartments was observed in the ID patients. Lung function and exercise capacity were associated with several markers of iron metabolism regulation. Iron status should be included in the overall assessment of COPD patients given its implications in their exercise performance. Full article

(This article belongs to the Special Issue Physiology and Pathophysiology of Iron Metabolism)

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16 pages, 2531 KiB

Open AccessArticle

Liposomal Mineral Absorption: A Randomized Crossover Trial

by Grant M. Tinsley, Patrick S. Harty, Matthew T. Stratton, Madelin R. Siedler and Christian Rodriguez

Nutrients 2022, 14(16), 3321; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14163321 - 13 Aug 2022

Cited by 1 | Viewed by 3814

Abstract

Multivitamin/mineral (MVM) supplements are one of the most popular dietary supplement categories. The purpose of this analysis was to determine if a novel liposomal delivery mechanism improves mineral absorption from an MVM product. In a randomized crossover trial, 25 healthy participants (12 females, 13 males) completed two testing sessions in which blood samples were collected at baseline and 2, 4, and 6 h following the ingestion of either a liposomal MVM or a nutrient-matched standard MVM. Analysis of MVM products indicated an elemental iron content of 9.4 and 10.1 mg (~50% U.S. FDA Daily Value) and an elemental magnesium content of 22.0 and 23.3 mg (~5% U.S. FDA Daily Value) in the liposomal and standard MVM products, respectively. Blood samples were analyzed for concentrations of iron and magnesium using colorimetric assays. Changes in mineral concentrations were analyzed using linear mixed models, and pharmacokinetic parameters were compared between conditions. For iron, statistically significant condition × time interactions were observed for percent change from baseline (p = 0.002), rank of percent change from baseline (p = 0.01), and raw concentrations (p = 0.02). Follow-up testing indicated that the liposomal condition exhibited larger changes from baseline than the standard MVM condition at 4 (p = 0.0001; +14.3 ± 18.5% vs. −6.0 ± 13.1%) and 6 h (p = 0.0002; +1.0 ± 20.9% vs. −21.0 ± 15.3%) following MVM ingestion. These changes were further supported by a 50% greater mean incremental area under the curve in the liposomal condition (33.2 ± 30.9 vs. 19.8 ± 19.8 mcg/dL × 6 h; p = 0.02, Cohen’s d effect size = 0.52). In contrast, no differential effects for magnesium absorption were observed. In conclusion, iron absorption from an MVM product is enhanced by a liposomal delivery mechanism. Full article

(This article belongs to the Special Issue Physiology and Pathophysiology of Iron Metabolism)

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9 pages, 709 KiB

Open AccessArticle

Heat-Killed Lactococcus lactis subsp. cremoris H61 Altered the Iron Status of Young Women: A Randomized, Double-Blinded, Placebo-Controlled, Parallel-Group Comparative Study

by Mizuki Takaragawa, Keishoku Sakuraba and Yoshio Suzuki

Nutrients 2022, 14(15), 3144; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14153144 - 30 Jul 2022

Cited by 2 | Viewed by 2614

Abstract

Women are prone to iron deficiency because of increased iron excretion associated with menstruation. This is often treated by oral iron supplementation, although this treatment can cause side effects, such as stomach pain and nausea, with low absorption of ingested iron. Previously, a significant increase in serum iron was observed in association with the consumption of foods containing Lactococcus lactis subsp. cremoris H61 (H61). However, the causal relationship between H61 ingestion and elevated serum iron is still unclear. Therefore, in this study, we aimed to determine the effects of H61 ingestion on the iron status of young women. Healthy young Japanese women (18–25 years of age) ingested either heat-killed H61 or placebo for 4 weeks. Serum iron, transferrin saturation, and ferritin were significantly elevated in the H61 group but remained unchanged in the placebo group. Compared to before the intervention, iron intake remained unchanged during the intervention period, so the change in the iron status of the H61 group was not due to increased iron intake. These results suggest that heat-killed H61 may elevate iron status by enhancing iron absorption. Full article

(This article belongs to the Special Issue Physiology and Pathophysiology of Iron Metabolism)

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10 pages, 505 KiB

Open AccessArticle

Iron Deficiency in Cystic Fibrosis: A Cross-Sectional Single-Centre Study in a Referral Adult Centre

by Hervé Lobbes, Stéphane Durupt, Sabine Mainbourg, Bruno Pereira, Raphaele Nove-Josserand, Isabelle Durieu and Quitterie Reynaud

Nutrients 2022, 14(3), 673; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14030673 - 05 Feb 2022

Cited by 3 | Viewed by 1789

Abstract

Iron deficiency (ID) diagnosis in cystic fibrosis (CF) is challenging because of frequent systemic inflammation. We aimed to determine the prevalence and risk factors of ID in adult patients with CF. We conducted a single-centre prospective study in a referral centre. ID was defined by transferrin saturation ≤16% or ferritin ≤20 (women) or 30 (men) μg/L, or ≤100 μg/L in the case of systemic inflammation. Apparent exacerbation was an exclusion criterion. We included 165 patients (78 women), mean age—31.1 ± 8.9 years. ID prevalence was 44.2%. ID was significantly associated with female gender (58.9% vs. 38%), lower age (29.4 ± 8.5 vs. 32.5 ± 9.1), lower body mass index (20.5 ± 2.2 vs. 21.3 ± 2.5), and Pseudomonas aeruginosa colonization (70.8% vs. 55.1%). Diabetes mellitus, antiacid drug use and low pulmonary function were more frequent in patients with ID with no statistical significance. The use of CFTR correctors was not associated with ID. In the multivariate analysis, ID was associated with female gender (OR 2.64, CI95% 1.31–5.31), age < 30 years (OR 2.30, CI95% 1.16–4.56), and P. aeruginosa (OR 2.09, CI95% 1.04–4.19). Full article

(This article belongs to the Special Issue Physiology and Pathophysiology of Iron Metabolism)

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11 pages, 1676 KiB

Open AccessArticle

Investigating the Links between Lower Iron Status in Pregnancy and Respiratory Disease in Offspring Using Murine Models

by Henry M. Gomez, Amber L. Pillar, Alexandra C. Brown, Richard Y. Kim, Md Khadem Ali, Ama-Tawiah Essilfie, Rebecca L. Vanders, David M. Frazer, Gregory J. Anderson, Philip M. Hansbro, Adam M. Collison, Megan E. Jensen, Vanessa E. Murphy, Daniel M. Johnstone, David Reid, Elizabeth A. Milward, Chantal Donovan and Jay C. Horvat

Nutrients 2021, 13(12), 4461; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13124461 - 14 Dec 2021

Cited by 3 | Viewed by 2521

Abstract

Maternal iron deficiency occurs in 40–50% of all pregnancies and is associated with an increased risk of respiratory disease and asthma in children. We used murine models to examine the effects of lower iron status during pregnancy on lung function, inflammation and structure, as well as its contribution to increased severity of asthma in the offspring. A low iron diet during pregnancy impairs lung function, increases airway inflammation, and alters lung structure in the absence and presence of experimental asthma. A low iron diet during pregnancy further increases these major disease features in offspring with experimental asthma. Importantly, a low iron diet increases neutrophilic inflammation, which is indicative of more severe disease, in asthma. Together, our data demonstrate that lower dietary iron and systemic deficiency during pregnancy can lead to physiological, immunological and anatomical changes in the lungs and airways of offspring that predispose to greater susceptibility to respiratory disease. These findings suggest that correcting iron deficiency in pregnancy using iron supplements may play an important role in preventing or reducing the severity of respiratory disease in offspring. They also highlight the utility of experimental models for understanding how iron status in pregnancy affects disease outcomes in offspring and provide a means for testing the efficacy of different iron supplements for preventing disease. Full article

(This article belongs to the Special Issue Physiology and Pathophysiology of Iron Metabolism)

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9 pages, 1497 KiB

Open AccessArticle

Does the Combined Effect of Resistance Training with EPO and Iron Sulfate Improve Iron Metabolism in Older Individuals with End-Stage Renal Disease?

by Hugo de Luca Corrêa, Víctor Manuel Alfaro-Magallanes, Sting Ray Gouveia Moura, Rodrigo Vanerson Passos Neves, Lysleine Alves Deus, Fernando Sousa Honorato, Victor Lopes Silva, Artur Temizio Oppelt Raab, Beatriz Carneiro Habbema Maia, Isabela Akaishi Padula, Lucas Santos de Gusmão Alves, Rafaela Araújo Machado, Andrea Lucena Reis, Jonato Prestes, Carlos Ernesto Santos Ferreira, Luiz Sinésio da Silva Neto, Fernanda Silveira Tavares, Rosângela Vieira Andrade and Thiago dos Santos Rosa

Nutrients 2021, 13(9), 3250; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13093250 - 18 Sep 2021

Cited by 2 | Viewed by 2625

Abstract

We sought to investigate the effects of resistance training (RT) combined with erythropoietin (EPO) and iron sulfate on the hemoglobin, hepcidin, ferritin, iron status, and inflammatory profile in older individuals with end-stage renal disease (ESRD). ESRD patients (n: 157; age: 66.8 ± 3.6; body mass: 73 ± 15; body mass index: 27 ± 3), were assigned to control (CTL; n: 76) and exercise groups (RT; n: 81). The CTL group was divided according to the iron treatment received: without iron treatment (CTL—none; n = 19), treated only with iron sulfate or EPO (CTL—EPO or IRON; n = 19), and treated with both iron sulfate and EPO (CTL—EPO + IRON; n = 76). The RT group followed the same pattern: (RT—none; n = 20), (RT—EPO or IRON; n = 18), and (RT—EPO + IRON; n = 86). RT consisted of 24 weeks/3 days per week at moderate intensity of full-body resistance exercises prior to the hemodialysis section. The RT group, regardless of the iron treatment, improved iron metabolism in older individuals with ESRD. These results provide some clues on the effects of RT and its combination with EPO and iron sulfate in this population, highlighting RT as an important coadjutant in ESRD-iron deficiency. Full article

(This article belongs to the Special Issue Physiology and Pathophysiology of Iron Metabolism)

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Review

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18 pages, 886 KiB

Open AccessReview

The Link between Iron Turnover and Pharmacotherapy in Transplant Patients

by Marcin Delijewski, Aleksandra Bartoń, Beata Maksym and Natalia Pawlas

Nutrients 2023, 15(6), 1453; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15061453 - 17 Mar 2023

Cited by 1 | Viewed by 1617

Abstract

Iron is a transition metal that plays a crucial role in several physiological processes. It can also exhibit toxic effects on cells, due to its role in the formation of free radicals. Iron deficiency and anemia, as well as iron overload, are the result of impaired iron metabolism, in which a number of proteins, such as hepcidin, hemojuvelin and transferrin, take part. Iron deficiency is common in individuals with renal and cardiac transplants, while iron overload is more common in patients with hepatic transplantation. The current knowledge about iron metabolism in lung graft recipients and donors is limited. The problem is even more complex when we consider the fact that iron metabolism may be also driven by certain drugs used by graft recipients and donors. In this work, we overview the available literature reports on iron turnover in the human body, with particular emphasis on transplant patients, and we also attempt to assess the drugs’ impact on iron metabolism, which may be useful in perioperative treatment in transplantology. Full article

(This article belongs to the Special Issue Physiology and Pathophysiology of Iron Metabolism)

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16 pages, 1063 KiB

Open AccessFeature PaperReview

Benefits and Risks of Early Life Iron Supplementation

by Shasta A. McMillen, Richard Dean, Eileen Dihardja, Peng Ji and Bo Lönnerdal

Nutrients 2022, 14(20), 4380; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14204380 - 19 Oct 2022

Cited by 8 | Viewed by 6420

Abstract

Infants are frequently supplemented with iron to prevent iron deficiency, but iron supplements may have adverse effects on infant health. Although iron supplements can be highly effective at improving iron status and preventing iron deficiency anemia, iron may adversely affect growth and development, and may increase risk for certain infections. Several reviews exist in this area; however, none has fully summarized all reported outcomes of iron supplementation during infancy. In this review, we summarize the risks and benefits of iron supplementation as they have been reported in controlled studies and in relevant animal models. Additionally, we discuss the mechanisms that may underly beneficial and adverse effects. Full article

(This article belongs to the Special Issue Physiology and Pathophysiology of Iron Metabolism)

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23 pages, 4295 KiB

Open AccessEditor’s ChoiceReview

The Dark Side of Iron: The Relationship between Iron, Inflammation and Gut Microbiota in Selected Diseases Associated with Iron Deficiency Anaemia—A Narrative Review

by Ida J. Malesza, Joanna Bartkowiak-Wieczorek, Jakub Winkler-Galicki, Aleksandra Nowicka, Dominika Dzięciołowska, Marta Błaszczyk, Paulina Gajniak, Karolina Słowińska, Leszek Niepolski, Jarosław Walkowiak and Edyta Mądry

Nutrients 2022, 14(17), 3478; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14173478 - 24 Aug 2022

Cited by 22 | Viewed by 11214

Abstract

Iron is an indispensable nutrient for life. A lack of it leads to iron deficiency anaemia (IDA), which currently affects about 1.2 billion people worldwide. The primary means of IDA treatment is oral or parenteral iron supplementation. This can be burdened with numerous side effects such as oxidative stress, systemic and local-intestinal inflammation, dysbiosis, carcinogenic processes and gastrointestinal adverse events. Therefore, this review aimed to provide insight into the physiological mechanisms of iron management and investigate the state of knowledge of the relationship between iron supplementation, inflammatory status and changes in gut microbiota milieu in diseases typically complicated with IDA and considered as having an inflammatory background such as in inflammatory bowel disease, colorectal cancer or obesity. Understanding the precise mechanisms critical to iron metabolism and the awareness of serious adverse effects associated with iron supplementation may lead to the provision of better IDA treatment. Well-planned research, specific to each patient category and disease, is needed to find measures and methods to optimise iron treatment and reduce adverse effects. Full article

(This article belongs to the Special Issue Physiology and Pathophysiology of Iron Metabolism)

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