Institute of Nutritional Science, Justus-Liebig University, Giessen, Germany.
Institute of Pharmaceutical Chemistry, Goethe University, Frankfurt, Germany.
Front Immunol. 2021 Mar 11;12:635899. doi: 10.3389/fimmu.2021.635899. eCollection 2021.
Iron deficiency, with or without anemia, is the most frequent hematological manifestation in individuals with cancer, and is especially common in patients with colorectal cancer. Iron is a vital micronutrient that plays an essential role in many biological functions, in the context of which it has been found to be intimately linked to cancer biology. To date, however, whereas a large number of studies have comprehensively investigated and reviewed the effects of excess iron on cancer initiation and progression, potential interrelations of iron deficiency with cancer have been largely neglected and are not well-defined. Emerging evidence indicates that reduced iron intake and low systemic iron levels are associated with the pathogenesis of colorectal cancer, suggesting that optimal iron intake must be carefully balanced to avoid both iron deficiency and iron excess. Since iron is vital in the maintenance of immunological functions, insufficient iron availability may enhance oncogenicity by impairing immunosurveillance for neoplastic changes and potentially altering the tumor immune microenvironment. Data from clinical studies support these concepts, showing that iron deficiency is associated with inferior outcomes and reduced response to therapy in patients with colorectal cancer. Here, we elucidate cancer-related effects of iron deficiency, examine preclinical and clinical evidence of its role in tumorigenesis, cancer progression and treatment response. and highlight the importance of adequate iron supplementation to limit these outcomes.
缺铁症（无论是否伴有贫血）是癌症患者最常见的血液学表现，尤其常见于结直肠癌患者。铁是一种重要的微量营养素，在许多生物学功能中发挥着重要作用，研究发现其与癌症生物学密切相关。然而，迄今为止，尽管大量研究全面调查和综述了过量铁对癌症发生和进展的影响，但铁缺乏与癌症之间的潜在相互关系在很大程度上被忽视了，并且尚未明确。新出现的证据表明，铁摄入减少和全身铁水平降低与结直肠癌的发病机制有关，这表明必须仔细平衡最佳铁摄入量，以避免铁缺乏和铁过剩。由于铁在维持免疫功能方面至关重要，因此铁供应不足可能通过损害对肿瘤变化的免疫监视并可能改变肿瘤免疫微环境而增强致癌性。来自临床研究的数据支持这些概念，表明缺铁症与结直肠癌患者的不良结局和治疗反应降低有关。在这里，我们阐明了缺铁症与癌症相关的影响，研究了其在肿瘤发生、癌症进展和治疗反应中的作用的临床前和临床证据，并强调了适当补充铁的重要性，以限制这些结果。
