Chieppa Marcello, Galleggiante Vanessa, Serino Grazia, Massaro Monica, Santino Angelo
Laboratory of Experimental Immunopathology, National Institute of Gastoenterology, Via Turi 27, 70013, Castellana Grotte (BA). Italy.
National Institute of Gastroenterology "S. de Bellis", Institute of Research, Castellana Grotte (BA). Italy.
Curr Pharm Des. 2017;23(16):2289-2298. doi: 10.2174/1381612823666170215143541.
The importance of hemoproteins for life lies largely in their iron-mediated chemical properties. In the human body, there are about 4 g of iron, a precious resource preserved by sophisticated recycling mechanisms. Iron is also important for pathogen growth, so it is not surprising that immune cells developed mechanisms to reduce iron availability in cases of inflammation. In healthy conditions, macrophages degrade hemoproteins and export iron, while if inflammation develops, they retain cytoplasmic iron to reduce extracellular iron concentrations. Iron-rich macrophages possess a stronger inflammatory ability, which explains the chronic inflammatory response observed in states of iron overload. Inflammatory bowel syndromes are often characterized by intestinal blood loss and consequent anemia, but iron-supplementation therapies may exacerbate the inflammatory response. In chronically transfused patients iron overload is frequently observed; the iron can become toxic and in excess, even fatal if not treated with iron-chelating drugs.
In the present review, we discuss the importance of iron homeostasis in states of health and inflammation, focusing on iron and iron-chelation treatment for IBD patients. Oral administration of natural ironchelating chemicals may be an effective adjuvant therapy for IBD patients, acting on numerous aspects of chronic inflammatory syndromes.
血红素蛋白对生命的重要性很大程度上在于其铁介导的化学性质。在人体中,约有4克铁,这是一种通过复杂的循环机制得以保存的珍贵资源。铁对病原体生长也很重要,因此免疫细胞在炎症情况下形成降低铁可用性的机制也就不足为奇了。在健康状态下,巨噬细胞降解血红素蛋白并输出铁,而如果发生炎症,它们会保留细胞质铁以降低细胞外铁浓度。富含铁的巨噬细胞具有更强的炎症能力,这解释了在铁过载状态下观察到的慢性炎症反应。炎症性肠综合征通常以肠道失血和随之而来的贫血为特征,但补充铁剂疗法可能会加剧炎症反应。在长期输血的患者中经常观察到铁过载;铁可能会变得有毒且过量,如果不使用铁螯合药物治疗甚至会致命。
在本综述中,我们讨论了铁稳态在健康和炎症状态下的重要性,重点关注炎症性肠病患者的铁及铁螯合治疗。口服天然铁螯合化学物质可能是炎症性肠病患者的一种有效辅助治疗方法,作用于慢性炎症综合征的多个方面。