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Iron deficiency, immunology, and colorectal cancer

Journal

NUTRITION REVIEWS
Volume 79, Issue 1, Pages 88-97

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/nutrit/nuaa040

Keywords

colorectal cancer; immunology; iron deficiency anemia; iron therapy; tumor microenvironment

Funding

  1. Tillotts Pharma
  2. Vifor Pharma (Switzerland)

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Iron levels play a crucial role in the pathogenesis of colorectal cancer, with both excessive and insufficient iron intake being associated with negative outcomes on cancer immunosurveillance and treatment response.
Excessive gut luminal iron contributes to the initiation and progression of colorectal cancer. However, emerging evidence suggests that reduced iron intake and low systemic iron levels are also associated with the pathogenesis of colorectal cancer. This is important because patients with colorectal cancer often present with iron deficiency. Iron is necessary for appropriate immunological functions; hence, iron deficiency may hinder cancer immunosurveillance and potentially modify the tumor immune microenvironment, both of which may assist cancer development. This is supported by studies showing that patients with colorectal cancer with iron deficiency have inferior outcomes and reduced response to therapy. Here, we provide an overview of the immunological consequences of iron deficiency and suggest ensuring adequate iron therapy to limit these outcomes.

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