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Archives de pédiatrie
Volume 24, n° 5S
pages 514-517 (mai 2017)
Doi : 10.1016/S0929-693X(17)24004-4
Fer et prédisposition aux infections
Iron and susceptibility to infections

L. de Pontual
 Service de pédiatrie, hôpital Jean-Verdier, AP-Hp université Paris 13, Bondy, France 


Le fer est un nutriment essentiel aussi bien pour assurer un bon fonctionnement des cellules du système immunitaire que pour contribuer à la croissance et la virulence des micro-organismes. Si la carence martiale augmente la susceptibilité aux infections, notamment celles dues aux micro-organismes intracellulaires, les situations de surcharge en fer comme l’hémochromatose peuvent au contraire augmenter la virulence de certains germes. La synthèse d’hepcidine est augmentée lors de la phase aiguë de l’inflammation, entraînant ainsi une diminution de l’absorption intestinale de fer et sa captation par les macrophages. Il s’agit d’un mécanisme de défense de l’enfant ayant pour but de limiter l’avidité du fer pour les micro-organismes extra-cellulaires. À l’inverse le fer affecte le fonctionnement de la réponse innée en diminuant la production d’IFN-γ et de NF-kB par les macrophages. Au total, la carence en fer favorise la survenue de certaines infections, mais l’excès de fer peut altérer la réponse des cellules du système immunitaire.

The full text of this article is available in PDF format.

Iron is essential for proper functioning of the host immune system as well as an essential nutrient for growth of various pathogens. Iron deficiency increases infection susceptibility, specially those due to intracellular pathogens. At the opposite, excess iron stores could increase the virulence of some pathogens. Hepcidin synthesis is increased during the acute inflammation phase; leading to decreased iron intestinal absorption and retention of the metal within macrophages. This is considered to result from a defense mechanism of the child to limit the availability of iron for extracellular pathogens. On the other hand, iron affect innate immune responses by influencing IFN-γ or NF-kB pathways in macrophages. Consequently, iron enhances host resistance to intracellular pathogens but excess iron may alter immune system.

The full text of this article is available in PDF format.

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