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Iron Deficiency, Anemia, and the Immune System

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Nutritional Anemia

Part of the book series: Nutrition and Health ((NH))

Abstract

Iron homeostasis is critical for human health, because both too little and too much iron may have severe clinical consequences. No other element can replace iron as component of hemoglobin and in iron-containing enzymes such as cytochromes. Iron deficiency (ID) results in anemia, impaired cell metabolism, and organ dysfunction. Conversely, when surplus iron exceeds the capacity of its storage protein ferritin, the redox instability of free iron generates oxygen radicals, which can damage parenchymal cells and inner organs.

Iron deficiency encompasses two pathophysiological distinct forms, absolute and functional iron deficiency. Absolute iron deficiency is the most frequent cause of anemia worldwide. It is therefore not only a common differential diagnosis and cause for further diagnostic workup in individual patients, but also a major public health concern. Functional iron deficiency in contrast results from immune-driven iron retention in monocytes and macrophages and causes iron-restricted erythropoiesis, anemia of inflammation, and, potentially, immune dysfunction.

Apart from the erythropoietic system, the immune system has an essential requirement of iron, too. Therefore, iron deficiency from different causes impairs immune cell proliferation and the defense against invading pathogens and malignant cells. Vice versa, iron overload facilitates the growth of microbes, thereby impairing innate immune mechanisms. Reflecting on these complex interactions, this chapter summarizes the basic principles of iron deficiency with a focus on our current understanding of its effects on the immune system.

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Authors and Affiliations

  1. Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck, Innsbruck, Austria

    Anna-Maria Mitterstiller, Laura von Raffay & Manfred Nairz

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  1. Anna-Maria Mitterstiller
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  2. Laura von Raffay
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Correspondence to Anna-Maria Mitterstiller .

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Editors and Affiliations

  1. Human Nutrition, The University of British Columbia, Vancouver, BC, Canada

    Crystal D. Karakochuk

  2. Institute of Food Nutrition and Health, ETH Zurich, Zürich, Zürich, Switzerland

    Michael B. Zimmermann

  3. Department of Health, University of Applied Sciences of South Switzerland (SUPSI) and Swiss Distance University of Applied Sciences (FFHS), Zürich, Zürich, Switzerland

    Diego Moretti

  4. International Health, Sight and Life Foundation and Johns Hopkins School of Public Health, Basel, Switzerland

    Klaus Kraemer

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Mitterstiller, AM., von Raffay, L., Nairz, M. (2022). Iron Deficiency, Anemia, and the Immune System. In: Karakochuk, C.D., Zimmermann, M.B., Moretti, D., Kraemer, K. (eds) Nutritional Anemia. Nutrition and Health. Springer, Cham. https://doi.org/10.1007/978-3-031-14521-6_18

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