The role of intestinal microbiocenosis in human iron metabolism

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Abstract

Intestinal dysbiosis is considered as an underestimated factor in iron deficiency anemia (IDA) pathogenesis. Of particular interest is the contribution of bacterial genus Desulfovibrio spp. and its metabolite hydrogen sulfide to impaired iron absorption and distribution. The aim: to summarize current data on the impact of dysbiosis on iron homeostasis. Publications were selected from international and Russian databases (PubMed/MEDLINE, Scopus, WoS, eLIBRARY, CyberLeninka) to include in the review original studies, systematic reviews, meta-analyses, and clinical guidelines. According to the results of relevant scientific literature analysis, iron deficiency and oral Fe²+ salts cause an imbalance in the microbiota with an increased growth of Proteobacteria (including Enterobacteriaceae) while decreasing the number of butyrate producers. Desulfovibrio spp. compete with host organism for iron and produce hydrogen sulfide, which damages the intestinal epithelium and can directly suppress ferroportin synthesis, reducing iron export from enterocytes. Thus, dysbiosis is a significant factor of IDA persistence. Further study of this problem and aspects of complex therapy for IDA, such as dysbiosis correction, choice of parenteral iron administration, and personalized monitoring of hepcidin levels, is necessary.

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About the authors

Lyutsiya A. Bityumina

Central Research Institute of Epidemiology of Rospotrebnadzor

Author for correspondence.
Email: bitumina@cmd.su
ORCID iD: 0000-0002-5378-0827

MD, researcher and bacteriologist at Research group for antibiotic resistance of food pathogens

Russian Federation, Moscow

Irina B. Koroleva

Central Research Institute of Epidemiology of Rospotrebnadzor

Email: martiusheva@cmd.su
ORCID iD: 0000-0002-9397-9646

MD, junior researcher at Research group for antibiotic resistance of food pathogens

Russian Federation, Moscow

Mikhail A. Vinokurov

Central Research Institute of Epidemiology of Rospotrebnadzor

Email: vinokurov@cmd.su
ORCID iD: 0000-0002-4101-0702

MD, PhD (Medicine), researcher at the Laboratory of molecular methods for genetic polymorphisms studying

Russian Federation, Moscow

Anastasia V. Gromova

Central Research Institute of Epidemiology of Rospotrebnadzor

Email: anastgromow@yandex.ru
ORCID iD: 0000-0003-4664-3178

MD, PhD (Veterinary medicine), researcher at the Laboratory of molecular diagnostics and epidemiology of reproductive organs’ infections

Russian Federation, Moscow

Nina G. Kulikova

Central Research Institute of Epidemiology of Rospotrebnadzor

Email: kulikova_ng@cmd.su
ORCID iD: 0000-0002-1716-6969

MD, PhD (Biology), head of Research group for antibiotic resistance of food pathogens

Russian Federation, Moscow

Antonina A. Ploskireva

Central Research Institute of Epidemiology of Rospotrebnadzor

Email: antoninna@mail.ru
ORCID iD: 0000-0002-3612-1889

MD, Dr. Sci. (Medicine), professor, professor of RAS, deputy director for clinical work

Russian Federation, Moscow

Alexander V. Gorelov

Central Research Institute of Epidemiology of Rospotrebnadzor

Email: agorelov_05@mail.ru
ORCID iD: 0000-0001-9257-0171

MD, Dr. Sci (Medicine), professor, academician of RAS, deputy director for research of Central Research Institute of Epidemiology of Rospotrebnadzor, head of the Department of infectious diseases and epidemiology, Russian University of Medicine of the Ministry of Healthcare of Russia

Russian Federation, Moscow

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2. Fig. The effect of bacteria of the genus Desulfovibrio spp. on iron metabolism in the gastrointestinal tract

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