Comparison of the effects of deferasirox, deferiprone, and deferoxamine on the growth and virulence of Vibrio vulnificus

BACKGROUND: Since deferoxamine (DFO), a standard iron-chelating agent that is widely used in patients with iron overload such as hemochromatosis or thalassemia, is a kind of hydroxamine siderophore of Streptomyces species, it can accelerate the in vitro growth of ferophilic organisms such as Vibrio vulnificus, Yersinia enterocolitica, and Mucorales. STUDY DESIGN AND METHODS: We compared the effects of the two oral iron chelators, deferiprone (DFP) and deferasirox (DFS), on the growth and virulence of V. vulnificus with that of the parenteral iron-chelating drug DFO used to treat patients with iron overload. RESULTS: When V. vulnificus ATCC 27562 was grown in iron-poor liquid medium with alpha,alpha'-dipryridyl, addition of DFO promoted its growth, whereas DFP and DFS did not. Only DFP and DFS showed growth inhibitory effect by chelating iron and causing iron deprivation. Similarly, on iron-poor agar plates, various clinical V. vulnificus strains were only able to grow around filter paper disks impregnated with DFO. Our in vitro study data showed that DFS or DFP has more potential clinical application for preventing V. vulnificus infection in patients receiving iron chelation therapy. CONCLUSIONS: When patients with iron overload need iron chelation therapy, especially in a population at high risk for V. vulnificus in its endemic season, DFS or DFP may be safely used rather than DFO.