Effects of Oral Iron Supplementation on Iron Homeostasis, Phagocytic Potential and Oxidative Stress in a Preclinical Rodent Model of Iron-deficiency Anemia with E. coli Bacteremic Sepsis

Iron deficiency anemia (IDA) impairs immune functions and may be responsible for high sepsis-related mortality in global south. Management protocol of severe acute malnutrition with suspected infections prohibits iron supplementation for initial 7-14 days despite lack of robust contemporary evidence in relevant clinical setting. We planned to investigate effect of oral iron supplementation on iron indices and oxidative stress in rat model of IDA and sepsis surviving for two days. Development of IDA caused higher lipid peroxidation, and lesser myeloperoxidase, glutathione peroxidase, superoxide dismutase and catalase activities. IDA-sepsis rats revealed phagocytic paralysis, and exaggerated hypoferremia evidenced by disproportionate rise in ferritin, and fall in iron and transferrin. IDA-sepsis rats also had greater increase in lipid peroxidation, and fall in superoxide dismutase and catalase. Dose-dependent rise in glutathione peroxidase and superoxide dismutase without rise in serum iron or lipid peroxidation with two days of iron supplementation in IDA-sepsis rats looks encouraging.