P020 Practice Patterns of Primary Care and Gastroenterology Physicians in the Management of Iron Deficiency Anemia in Inflammatory Bowel Disease

Wade, Francis; Odufalu, Florence-Damilola; Grosch, G; Chambers, Melissa; Schroeder, Katie

doi:10.1053/j.gastro.2019.11.219

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“…Iron deficiency and the resulting anemia are currently poorly managed in IBD patients 61 . The ability of pentanoate to promote both iron uptake and colonic Treg homeostasis may provide strategies to alleviate intestinal inflammation as well as iron-deficient anemia in subjects with colitis.…”

Section: Resultsmentioning

confidence: 99%

Microbiota-assisted iron uptake promotes immune tolerance in the intestine

Zhu

Liang

et al. 2023

Nat Commun

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Iron deficiencies are the most common nonenteric syndromes observed in patients with inflammatory bowel disease, but little is known about their impacts on immune tolerance. Here we show that homeostasis of regulatory T cells in the intestine was dependent on high cellular iron levels, which were fostered by pentanoate, a short-chain fatty acid produced by intestinal microbiota. Iron deficiencies in Treg caused by the depletion of Transferrin receptor 1, a major iron transporter, result in the abrogation of Treg in the intestine and lethal autoimmune disease. Transferrin receptor 1 is required for differentiation of c-Maf+ Treg, major constituents of intestinal Treg. Mechanistically, iron enhances the translation of HIF-2α mRNA, and HIF-2α in turn induces c-Maf expression. Importantly, microbiota-produced pentanoate promotes iron uptake and Treg differentiation in the intestine. This subsequently restores immune tolerance and ameliorated iron deficiencies in mice with colitis. Our results thus reveal an association between nutrient uptake and immune tolerance in the intestine.

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Section: Resultsmentioning

confidence: 99%