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The critical roles of iron during the journey from fetus to adolescent: Developmental aspects of iron homeostasis

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BLOOD REVIEWS
卷 50, 期 -, 页码 -

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CHURCHILL LIVINGSTONE
DOI: 10.1016/j.blre.2021.100866

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Iron homeostasis; Hepcidin; Pediatrics; Gut microbiome; Immune system; Neurocognitive development

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Iron is essential for human life, but can be toxic if not tightly regulated. Children and developing individuals have high iron demands, and imbalanced iron status early in life can have lasting effects on the nervous system, immune system, and gut microbiota.
Iron is indispensable for human life. However, it is also potentially toxic, since it catalyzes the formation of harmful oxidative radicals in unbound form and may facilitate pathogen growth. Therefore, iron homeostasis needs to be tightly regulated. Rapid growth and development require large amounts of iron, while (especially young) children are vulnerable to infections with iron-dependent pathogens due to an immature immune system. Moreover, unbalanced iron status early in life may have effects on the nervous system, immune system and gut microbiota that persist into adulthood. In this narrative review, we assess the critical roles of iron for growth and development and elaborate how the body adapts to physiologically high iron demands during the journey from fetus to adolescent. As a first step towards the development of clinical guidelines for the management of iron disorders in children, we summarize the unmet needs regarding the developmental aspects of iron homeostasis.

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