Absolute and functional iron deficiency: Biomarkers, impact on immune system, and therapy

Iron is essential for numerous physiological processes and its deficiency often leads to anemia. Iron deficiency (ID) is a global problem, primarily affecting reproductive-age women and children, especially in developing countries. Diagnosis uses classical biomarkers like ferritin or transferrin sat...

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Veröffentlicht in:Blood reviews 2024-11, Vol.68, p.101227, Article 101227
Hauptverfasser: Iriarte-Gahete, Marianela, Tarancon-Diez, Laura, Garrido-Rodríguez, Vanesa, Leal, Manuel, Pacheco, Yolanda María
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Sprache:eng
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Zusammenfassung:Iron is essential for numerous physiological processes and its deficiency often leads to anemia. Iron deficiency (ID) is a global problem, primarily affecting reproductive-age women and children, especially in developing countries. Diagnosis uses classical biomarkers like ferritin or transferrin saturation. Recent advancements include using soluble transferrin receptor (sTfR) or hepcidin for improved detection and classification of absolute and functional iron deficiencies, though mostly used in research. ID without anemia may present symptoms like asthenia and fatigue, even without relevant clinical consequences. ID impacts not only red-blood cells but also immune system cells, highlighting its importance in global health and immune-related comorbidities. Managing ID, requires addressing its cause and selecting appropriate iron supplementation. Various improved oral and intravenous products are available, but further research is needed to refine treatment strategies. This review updates on absolute and functional iron deficiencies, their relationships with the immune system and advancements in diagnosis and therapies. •Diagnosis of ID, beyond anemia, is crucial, but limited with traditional biomarkers.•sTfR and hepcidin biomarkers can improve ID diagnosis, even in inflamed contexts.•ID can affect vaccine response, immune memory and other immunity-related factors.•Most knowledge of immune consequences of ID is based on in vitro or animal models.•IV iron is a suitable option, not only in poor oral tolerance or urgent replacemen.
ISSN:0268-960X
1532-1681
1532-1681
DOI:10.1016/j.blre.2024.101227