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Intravenous iron is non-inferior to oral iron regarding cell growth and iron metabolism in colorectal cancer associated with iron-deficiency anaemia
Al-Hassi, Hafid Omar Ng, Oliver Evstatiev, R Mangalika, Manel Worton, Natalie Jambrich, M Khare, V Keeler, Barrie Gasche, C
Al-Hassi, Hafid Omar
Ng, Oliver
Evstatiev, R
Mangalika, Manel
Worton, Natalie
Jambrich, M
Khare, V
Keeler, Barrie
Gasche, C
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2021-07-01
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Abstract
Oral iron promotes intestinal tumourigenesis in animal models. In humans, expression of iron transport proteins are altered in colorectal cancer. This study examined whether the route of iron therapy alters iron transport and tumour growth. Colorectal adenocarcinoma patients with pre-operative iron deficiency anaemia received oral ferrous sulphate (n = 15), or intravenous ferric carboxymaltose (n = 15). Paired (normal and tumour tissues) samples were compared for expression of iron loading, iron transporters, proliferation, apoptosis and Wnt signalling using immunohistochemistry and RT-PCR. Iron loading was increased in tumour and distributed to the stroma in intravenous treatment and to the epithelium in oral treatment. Protein and mRNA expression of proliferation and iron transporters were increased in tumours compared to normal tissues but there were no significant differences between the treatment groups. However, intravenous iron treatment reduced ferritin mRNA levels in tumours and replenished body iron stores. Iron distribution to non-epithelial cells in intravenous iron suggests that iron is less bioavailable to tumour cells. Therefore, intravenous iron may be a better option in the treatment of colorectal cancer patients with iron deficiency anaemia due to its efficiency in replenishing iron levels while its effect on proliferation and iron metabolism is similar to that of oral iron treatment.
Citation
Al-Hassi, H.O., Ng, O., Evstatiev, R. et al. (2021) Intravenous iron is non-inferior to oral iron regarding cell growth and iron metabolism in colorectal cancer associated with iron-deficiency anaemia. Scientific Reports, 11, 13699. https://doi.org/10.1038/s41598-021-93155-2
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34211054 (pubmed)
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Journal article
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en
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© 2021 The Authors. Published by Springer. 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/10.1038/s41598-021-93155-2
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2045-2322
EISSN
2045-2322
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Licence for published version: Creative Commons Attribution 4.0 International