An Insight into the Practice of Iron Therapy: Contribution to the On-going Debate with Special Reference to Low- and Middle-income Countries
DOI:
https://doi.org/10.52981/sjms.v16i1.1094Keywords:
iron deficiency anemia, hepcidin, oxidative stress, iron therapyAbstract
Background: Iron deficiency anemia is a public health problem of a sizable proportion
in developing countries. Recently, emerging biochemical knowledge coupled with the
discovery of Hepcidin have greatly advanced our understanding of iron metabolism
and offered a better insight into its associated pathophysiology. This knowledge should
be applied to iron-deficiency anemia therapy to avoid subsequent sequelae of tissue
damage associated with reactive oxygen radicals that are catalyzed by iron, because
current practices do not include these advances in the treatment guidelines. In the light
of recent progress, the existing iron therapy program in many healthcare settings is
controversial. This necessitates adjusting the magnitude of iron dose with respect
to the very limited iron bioavailability, as gauged by Hepcidin. The current study
was therefore aimed to incorporate newly emerging biochemical knowledge into the
current iron-deficiency anemia treatment practice
Methods: Literature relevant to iron-deficiency studies published in English between
1964 and 2020 and available online was covered.
Conclusion: Evidently, the existing iron-therapy schedule is both inefficient and toxic.
The intricate metabolism of iron should be translated into a more rational iron
intervention program with special bias towards low- and middle-income countries
requiring a more individualized approach.
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[12] Chaparro, C. M. and Suchdev, P. S. (2019). Anemia epidemiology, pathophysiology,and etiology in low- and middle-income countries. Annals of the New York Academyof Sciences, vol. 1450, no. 1, pp. 15–31. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697587/
[13] Killip, S., Bennet, J. M., and Chambers, M. D. (2007). Iron deficiency anemia. AmericanFamily Physician, vol. 75, no. 5, pp. 671–678. Retrieved from: https://www.aafp.org/afp/2007/0301/p671.html
[14] Qu, X. H., Huang, X. L., Xiong, P., et al. (2010). Does Helicobacter pylori infection playa role in iron deficiency anemia? A meta-analysis. World Journal of Gastroenterology,vol. 16, no. 7, pp. 886–896. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825337/
[15] Yiannikourides, A. and Latunde-Dada, G. O. (2019). A short review on iron metabolismand pathophysiology of iron disorders. Medicines, vol. 6, no. 3, p. 85. Retrieved from:https://www.mdpi.com/2305-6320/6/3/85
[16] Iuchi, Y. (2012). Anemia caused by oxidative stress. In: D. S. Silverberg (Ed.) [Internet].London: IntechOpen. Retrieved from: https://www.intechopen.com/books/anemia/anemia-caused-by-oxidative-stress. doi: 10.5772/31404
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[18] Munoz, M., Villar, I., and Garcia-Erce, J. A. (2009). An update on iron physiology.World Journal of Gastroenterology, vol. 15, no. 37, pp. 4617–4626. Retrieved from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754509/
[19] Ma, Y., Yeh, M., Yeh, K., et al. (2006). Iron Imports. V. transport of iron throughthe intestinal epithelium. American Journal of Physiology-Gastrointestinal and LiverPhysiology, vol. 290, no. 3, pp. 417–422. Retrieved from: https://journals.physiology.org/doi/full/10.1152/ajpgi.00489.2005
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