Oral and intravenous iron therapy differentially alter the on- and off-tumor microbiota in anemic colorectal cancer patients
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Authors
Phipps, OliverAl-Hassi, Hafid Omar
Quraishi, Mohammed Nabil
Dickson, Edward A
Segal, Jonathan
Steed, Helen
Kumar, Aditi
Acheson, Austin G
Beggs, Andrew D
Brookes, Matthew J
Issue Date
2021-03-16
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Show full item recordAbstract
Iron deficiency anemia is a common complication of colorectal cancer and may require iron therapy. Oral iron can increase the iron available to gut bacteria and may alter the colonic microbiota. We performed an intervention study to compare oral and intravenous iron therapy on the colonic tumor-associated (on-tumor) and paired non-tumor-associated adjacent (off-tumor) microbiota. Anemic patients with colorectal adenocarcinoma received either oral ferrous sulphate (n = 16) or intravenous ferric carboxymaltose (n = 24). On- and off-tumor biopsies were obtained post-surgery and microbial profiling was performed using 16S ribosomal RNA analysis. Off-tumor α- and β-diversity were significantly different between iron treatment groups. No differences in on-tumor diversity were observed. Off-tumor microbiota of oral iron-treated patients showed higher abundances of the orders Clostridiales, Cytophagales, and Anaeroplasmatales compared to intravenous iron-treated patients. The on-tumor microbiota was enriched with the orders Lactobacillales and Alteromonadales in the oral and intravenous iron groups, respectively. The on- and off-tumor microbiota associated with intravenous iron-treated patients infers increased abundances of enzymes involved in iron sequestration and anti-inflammatory/oncogenic metabolite production, compared to oral iron-treated patients. Collectively, this suggests that intravenous iron may be a more appropriate therapy to limit adverse microbial outcomes compared to oral iron.Citation
Phipps O, Al-Hassi HO, Quraishi MN, Dickson EA, Segal J, Steed H, Kumar A, Acheson AG, Beggs AD, Brookes MJ. (2021) Oral and Intravenous Iron Therapy Differentially Alter the On- and Off-Tumor Microbiota in Anemic Colorectal Cancer Patients. Cancers. 2021; 13(6):1341. https://doi.org/10.3390/cancers13061341Publisher
MDPIJournal
CancersAdditional Links
https://doi.org/10.3390/cancers13061341Type
Journal articleLanguage
enDescription
© 2021 The Authors. Published by MDPI. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.3390/cancers13061341ISSN
2072-6694Sponsors
The Ferinject™ used in the original IVICA trial was donated to all study centers, except Nottingham University Hospitals NHS Trust, by Vifor Pharma (Glattbrugg, Switzerland). The study represents independent research funded by the National Institute for Health Research (NIHR) Research for Patient Benefit (RfPB) program (grant number PB-PG-0110-21041).ae974a485f413a2113503eed53cd6c53
10.3390/cancers13061341
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Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by/4.0/