INTESTINAL MICROBIOTA IN THE REGULATION OF IRON METABOLISM: IMPACT ON THE PEPTIDE HORMONE HEPCIDIN
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Iron is essential for processes such as oxygen transport, cellular respiration, and DNA synthesis, but both deficiency and excess can lead to significant physiological alterations. Hepcidin, synthesized primarily in hepatocytes, has emerged as the central regulator of systemic iron metabolism by inducing the internalization and degradation of ferroportin, thereby reducing intestinal absorption and iron release from macrophages and hepatocytes. The gut microbiota, composed of trillions of microorganisms with metabolic and immunological functions, also modulates this regulatory network. Studies in animal models indicate that it regulates hepcidin expression and serum iron concentration. Furthermore, intestinal dysbiosis, which promotes systemic inflammation, increases hepcidin and contributes to inflammation-associated anemia. On the other hand, available evidence suggests that probiotics and prebiotics can favorably influence iron absorption, possibly by modulating the microbiota, intestinal integrity, and reducing hepcidin. This review addresses the relationship between gut microbiota, hepcidin and iron homeostasis, highlighting its relevance in anemia.
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