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Nutritional iron turned inside out: intestinal stress from a gut microbial perspective
Open accessAbstract
Iron is abundantly present on earth, essential for most microorganisms and crucial for human health.Human iron deficiency that is nevertheless highly prevalent in developing regions of the world can be effectively treated by oral iron administration.Accumulating evidence indicates that excess of unabsorbed iron that enters the colonic lumen causes unwanted side effects at the intestinal host-microbiota interface.The chemical properties of iron, the luminal environment and host iron withdrawal mechanisms, especially during inflammation, can turn the intestine in a rather stressful milieu.Certain pathogenic enteric bacteria can, however, deal with this stress at the expense of other members of the gut microbiota, while their virulence also seems to be stimulated in an iron-rich intestinal environment.This review covers the multifaceted aspects of nutritional iron stress with respect to growth, composition, metabolism and pathogenicity of the gut microbiota in relation to human health.We aim to present an unpreceded view on the dynamic effects and impact of oral iron administration on intestinal host-microbiota interactions to provide leads for future research and other applications. Summary and scope of this reviewIron is a highly abundant metal on earth and is vital for virtually all organisms, including most bacterial species.Nonetheless, iron deficiency is the most prevalent human nutrition disorder worldwide and is generally treated by oral iron administration.Notably, accumulating evidence suggests that unabsorbed iron can stimulate growth and virulence of bacterial pathogens in the intestinal environment.Simultaneously, host iron status influences the local defence against pathogens.Salmonella enterica serovar Typhimurium, a highly prevalent intestinal pathogen around the world, is one example of a pathogenic bacterial species that can deal with the stress of iron limitation, iron abundance and host defence factors.It is able to adapt to these environmental triggers and exploit the environment to thrive at the expense of other bacterial species.In this review, we will thoroughly discuss many different factors that are involved in iron-mediated host-pathogen interactions in the intestinal tract at the molecular level.We will first give a concise introduction in gut microbiology and nutritional stress.The central part of this review will present current knowledge about the effects of luminal iron on gut immunology and on the gut microbiota with respect to bacterial composition, pathogenicity and metabolism.These and other factors will also be related to pathogen stress in the gut lumen and are summarised in Fig. 1.Furthermore, we will mostly focus on S. Typhimurium and its ways to deal with environmental stress and to turn the external situation in favour of its own growth and colonisation.Finally, we will place the topics we discussed in the context of serious threats that persist in tropical Africa, such as infectious diarrhoea and S. Typhimurium infection that is often associated with invasive disease in this region. General introduction Gut microbiology and healthThe human gut is the natural habitat for a unique large and dynamic bacterial community that greatly
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“In particular, proliferation and activity of the bacterium Escherichia coli is facilitated by the presence of iron in the colonic lumen, suggesting enhanced pathogenicity in the setting of unregulated iron availability.”
From Overview of lunar dust toxicity risk (2022) · cites this paper as [52]
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“Interestingly, although sufficient iron may be present in the gastrointestinal tract, more specifically the colonic lumen, mostly due to excess dietary iron, it may have limited availability to microbiota. This is due to dietary molecules such as polyphenol and phytate as well as metabolic by-products that sequester available iron (reviewed by Kortman et al., 2014).”
From Iron at the Centre of Candida albicans Interactions (2018) · cites this paper as Kortman et al., 2014
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“recent studies suggest that the high availability of iron in the gastrointestinal tract may enhance expression of virulent factors in pathogenic bacteria52.”
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“It leads to a more diverse oral microbial community [23]”
From High iron-mediated increased oral fungal burden, oral-to-gut transmission, and changes to pathogenicity of Candida albicans in oropharyngeal candidiasis (2022) · cites this paper as [23]
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Metadata
- Authors
- Kortman, G. A. M., Raffatellu, M., Swinkels, D. W., & Tjalsma, H.
- Affiliations
- Radboud University Medical Center (NL)
- University of California, Irvine (US)
- Venue
- FEMS Microbiology Reviews
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-11
- Volume
- 38
- Issue
- 6
- Pages
- 1202-1234
- ISSN
- 0168-6445 (ISSN-L)
- 1574-6976
- OpenAlex
- W2110302416
- Semantic Scholar
- 12883cc5aa8bb7572bc2d56537b17a16503466ea
- Cited by
- 291
- References
- 227
- Citations by year
- 2026: 26 · 2025: 24 · 2024: 18 · 2023: 38 · 2022: 34 · 2021: 21 · 2020: 21 · 2019: 28 · 2018: 22 · 2017: 34 · 2016: 12 · 2015: 13
- FWCI
- 1.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- FEMS Microbiology Reviews (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (U54AI065359)
- Dutch Digestive Diseases Foundation (WO 10-53)
- Public Health Service Grants (AI083663, AI105374)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Life Sciences › Immunology and Microbiology › Microbiology › Escherichia coli research studies
- Keywords
- iron deficiency, oral iron supplementation, gut microbiota, host-microbiota interactions, Salmonella typhimurium, iron limitation, iron acquisition, bacterial virulence, intestinal inflammation, intestinal immunity, colonic lumen, bacterial metabolism, bacterial community composition
- MeSH terms
- Bacteria, Humans, Intestines, Iron, Oxidation-Reduction, Stress, Physiological, Iron, Dietary, Biodiversity, Host-Pathogen Interactions
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