Iron Toxicity and Chelating Therapy

Abstract

Iron is one of the most common elements on Earth and yet, because of its low solubility in nature, iron deficiency is one of the most common forms of nutritional deficiency. Because of the biological importance of iron as a catalyzer of one-electron redox reactions, evolution has provided us with efficient mechanisms for the acquisition, transfer and storage of iron, but not with mechanisms for the excretion of excess iron. The clinical consequences of iron accumulation in hemochromatosis are manifested in abnormal function of a number of vital organs, the most important of which is the heart. In the following, I would like to focus on four aspects of iron toxicity and chelation: (a) Studies conducted in an in vitro model of iron chelation and toxicity in rat myocardial cell cultures; (b) Evidence for the clinical effectiveness of iron chelating therapy in transfusional iron overload; (c) The potential usefulness of iron chelators in diseases unrelated to iron overload, and; (d) The development of new orally active iron chelators.