Peggy L. Carver* Pages 85 - 96 ( 12 )
Background: Iron is an essential micronutrient for bacteria, fungi, and humans; as such, each has evolved specialized iron uptake systems to acquire iron from the extracellular environment.
Objective: To describe complex ‘tug of war’ for iron that has evolved between human hosts and pathogenic microorganisms in the battle for this vital nutrient.
Methods: A review of current literature was performed, to assess current approaches and controversies in iron therapy and chelation in humans.
Results: In humans, sequestration (hiding) of iron from invading pathogens is often successful; however, many pathogens have evolved mechanisms to circumvent this approach.
Conclusion: Clinically, controversy continues whether iron overload or administration of iron results in an increased risk of infection. The administration of iron chelating agents and siderophore- conjugate drugs to infected hosts seems a biologically plausible approach as adjunctive therapy in the treatment of infections caused by pathogens dependent on host iron supply (e.g. tuberculosis, malaria, and many bacterial and fungal pathogens); however, thus far, studies in humans have proved unsuccessful.
Infection, iron, nutritional immunity, siderophore, iron overload, iron chelation.
Department of Clinical Pharmacy, University of Michigan, College of Pharmacy, Ann Arbor, MI 48109- 1065