Depletion of luminal iron alters the gut microbiota and prevents Crohn's disease-like ileitis
Abstract
BACKGROUND: Iron replacement therapy is a common treatment in patients with anaemia and Crohn's disease, but oral iron supplements are less tolerated. The pathogenesis of Crohn's disease is attributed to intestinal bacteria and environmental factors that trigger disease in a genetically predisposed host. The aim of this study was to characterise the interrelationship between luminal iron sulfate, systemic iron, the gut microbiota and the development of chronic ileitis in a murine model of Crohn's disease. METHODS: Wild type (WT) and heterozygous TNF(ΔARE/WT) mice were fed with an iron sulfate containing or iron sulfate free diet in combination with intraperitoneal control injections or iron injections for 11 weeks. RESULTS: TNF(ΔARE/WT) mice develop severe inflammation of the distal ileum but remained completely healthy when transferred to an iron sulfate free diet, even if iron was systemically repleted. Absence of luminal iron sulfate reduced cellular markers of endoplasmic reticulum (ER) stress responses and pro-apoptotic mechanisms in the ileal epithelium. Phenotype or reactivity of major effector intraepithelial CD8αβ(+) T cells were not altered in the absence of luminal iron. Interestingly, ER stress mechanisms sensitised the small intestinal epithelial cell (IEC) line Mode-K to cytotoxic function of effector T cells from TNF(ARE/WT) mice. Pyrosequencing of 16S rRNA tags of the caecal microbiota revealed that depletion of luminal iron sulfate induced significant compositional alterations, while total microbial diversity (Shannon's diversity index) and number of total operational taxonomic units were not affected. CONCLUSION: This study showed that an iron sulfate free diet in combination with systemic iron repletion prevents the development of chronic ileitis in a murine model of Crohn's disease. Luminal iron may directly affect IEC function or generate a pathological milieu in the intestine that triggers epithelial cell stress-associated apoptosis through changes in microbial homeostasis. These results suggest that oral replacement therapy with iron sulfate may trigger inflammatory processes associated with progression of Crohn's disease-like ileitis.
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Excess luminal iron can affect the composition of the microbiome and stimulate the immune response in the lamina propria.
“Therein, excess luminal iron can affect the composition of the microbiome and stimulate the immune response in the lamina propria (Werner et al., 2010).”
From Iron in infection and immunity (2020) · cites this paper as Werner et al., 2010
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Self-citation
- Authors
- Werner, T., Wagner, S. J., Martínez, I., Walter, J., Chang, J.-S., Clavel, T., Kisling, S., Schuemann, K., & Haller, D.
- Affiliations
- Technical University of Munich (DE)
- University of Nebraska–Lincoln (US)
- Corresponding author
- Haller, Dirk
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2010-11-12
- Volume
- 60
- Issue
- 3
- Pages
- 325-333
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- OpenAlex
- W2148251643
- Cited by
- 299
- References
- 25
- Citations by year
- 2026: 6 · 2025: 16 · 2024: 15 · 2023: 20 · 2022: 20 · 2021: 18 · 2020: 16 · 2019: 22 · 2018: 22 · 2017: 17 · 2016: 20 · 2015: 22 · 2014: 26 · 2013: 24 · 2012: 21
- FWCI
- 10.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gut (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Keywords
- iron sulfate, Crohn's disease, ileitis, gut microbiota, endoplasmic reticulum stress, epithelial apoptosis, CD8αβ T cells, TNF-deficient mice, oral iron supplementation, iron repletion, intestinal epithelium, microbial homeostasis
- MeSH terms
- Iron Deficiencies, Animals, Cecum, Cell Line, Chronic Disease, Crohn Disease, Disease Models, Animal, Endoplasmic Reticulum, Ileitis, Ileum, Intestinal Mucosa, Iron, Mice, Inbred C57BL, Stress, Physiological, T-Lymphocytes, Cytotoxic, Apoptosis, Coculture Techniques, Iron, Dietary, Mice
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