How severe anaemia might influence the risk of invasive bacterial infections in African children
File(s)
Published version
Author(s)
Abuga, KM
Muriuki, JM
Williams, Thomas
Atkinson, SH
Type
Journal Article
Abstract
Severe anaemia and invasive bacterial infections are common causes of childhood sickness and death in sub-Saharan Africa. Accumulating evidence suggests that severely anaemic African children may have a higher risk of invasive bacterial infections. However, the mechanisms underlying this association remain poorly described. Severe anaemia is characterized by increased haemolysis, erythropoietic drive, gut permeability, and disruption of immune regulatory systems. These pathways are associated with dysregulation of iron homeostasis, including the downregulation of the hepatic hormone hepcidin. Increased haemolysis and low hepcidin levels potentially increase plasma, tissue and intracellular iron levels. Pathogenic bacteria require iron and/or haem to proliferate and have evolved numerous strategies to acquire labile and protein-bound iron/haem. In this review, we discuss how severe anaemia may mediate the risk of invasive bacterial infections through dysregulation of hepcidin and/or iron homeostasis, and potential studies that could be conducted to test this hypothesis.
Date Issued
2020-09-22
Date Acceptance
2020-09-15
Citation
International Journal of Molecular Sciences, 2020, 21 (18)
ISSN
1422-0067
Publisher
MDPI AG
Journal / Book Title
International Journal of Molecular Sciences
Volume
21
Issue
18
Copyright Statement
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
License URL
Sponsor
Wellcome Trust
Wellcome Trust
Grant Number
203077/Z/16/Z (C161)
202800/Z/16/Z
Subjects
E. coli
Haemophilus
Mendelian randomization
Salmonella
Staphylococcus
Streptococcus
bacteraemia
hepcidin
iron
severe anaemia
Chemical Physics
0399 Other Chemical Sciences
0604 Genetics
0699 Other Biological Sciences
Publication Status
Published
Article Number
ART 6976