Ironing out mechanisms of iron homeostasis and disorders of iron deficiency

• Published in: The Journal of clinical investigation 2021-06, Vol.131 (11)
• Main Authors: Koleini, Navid, Shapiro, Jason S, Geier, Justin, Ardehali, Hossein
• Format: Article
• Language: English
• Subjects: Adult; Anemia, Iron-Deficiency - drug therapy; Anemia, Iron-Deficiency - metabolism; Animals; Child; Chronic Disease; Complications and side effects; Development and progression; Fetal Development - drug effects; Health aspects; Heart Failure - drug therapy; Heart Failure - metabolism; Homeostasis; Humans; Iron - metabolism; Iron - therapeutic use; Iron Deficiencies; Iron deficiency diseases; Iron in the body; Neoplasms - drug therapy; Neoplasms - metabolism; Physiological aspects; Reactive Oxygen Species - metabolism; Review
• ISSN: 1558-8238; 0021-9738; 1558-8238
• DOI: 10.1172/JCI148671

Iron plays an important role in mammalian physiological processes. It is a critical component for the function of many proteins, including enzymes that require heme and iron-sulfur clusters. However, excess iron is also detrimental because of its ability to catalyze the formation of reactive oxygen species. As a result, cellular and systemic iron levels are tightly regulated to prevent oxidative damage. Iron deficiency can lead to a number of pathological conditions, the most prominent being anemia. Iron deficiency should be corrected to improve adult patients' symptoms and to facilitate normal growth during fetal development and childhood. However, inappropriate use of intravenous iron in chronic conditions, such as cancer and heart failure, in the absence of clear iron deficiency can lead to unwanted side effects. Thus, this form of therapy should be reserved for certain patients who cannot tolerate oral iron and need rapid iron replenishment. Here, we will review cellular and systemic iron homeostasis and will discuss complications of iron deficiency.