Why are people with iron overload at increased risk for infections?

People with iron overload are at an increased risk of infections due to several factors:

Impaired immune function: Iron overload can disrupt the normal function of immune cells, including neutrophils and macrophages, which play crucial roles in defending against infections. Excess iron can interfere with the production and activity of these immune cells, impairing their ability to recognize and eliminate pathogens.

Increased bacterial growth: Iron is an essential nutrient for many bacteria, and its presence in excess can promote bacterial growth and replication. The high iron levels in individuals with iron overload provide a favorable environment for the proliferation of bacteria, increasing the risk of infections.

Altered gut microbiome: Iron overload has been associated with changes in the composition of the gut microbiome, the community of microorganisms residing in the intestines. Dysbiosis, an imbalance in the gut microbiota, can affect the intestinal barrier function and immune responses, making individuals more susceptible to infections.

Impaired antioxidant defenses: Iron overload can lead to an increase in oxidative stress, a state of imbalance between the production of reactive oxygen species (ROS) and the body's antioxidant defenses. Excessive ROS can damage cells, including immune cells, and impair their ability to function properly, further contributing to the risk of infections.

Hepatic dysfunction: In severe cases of iron overload, the liver can be damaged, leading to liver dysfunction. The liver plays crucial roles in immune responses and the production of essential proteins involved in infection control. Liver damage impairs these functions and compromises the body's ability to fight off infections.

Therefore, the combination of impaired immune function, increased bacterial growth, altered gut microbiome, impaired antioxidant defenses, and hepatic dysfunction all contribute to the increased risk of infections in individuals with iron overload.