# Molecular Mechanisms of Intestinal Metal Ion Transport During Iron Deficiency

> **NIH NIH R01** · UNIVERSITY OF FLORIDA · 2021 · $475,136

## Abstract

Project Summary
Iron deficiency (ID) is common in the U.S, causing significant morbidity. The inability to assimilate adequate
amounts of dietary iron, due to increased demands (e.g. with excessive menstrual blood loss) or impaired
utilization (e.g. iron malabsorption after gastric bypass surgery), frequently underlies ID. Women of child-
bearing age, pregnant women, the elderly (in whom achlorhydria is common), and children and adolescents
are commonly iron deficient; in these individuals, iron supplementation may be recommended. During
pregnancy, anemia is common since dietary iron assimilation is often inadequate to meet iron demands to
supply the developing fetus and for expansion of the maternal blood supply; iron supplementation is thus
almost universally recommended. Importantly, we recently noted that high dietary iron caused severe copper
deficiency, in rats and mice, with pathological consequences. These initial studies utilized supraphysiologic
iron levels (>100-fold excess), but a subsequent experiment demonstrated that iron at ~4X above requirements
resulted in moderate copper deficiency in rats. ID humans may consume iron at 4 times the RDA from dietary
and supplemental sources. It was previously suggested that high-iron intake can antagonize copper, but this
has not been validated by rigorous experimentation in animals or humans. This background then provides the
rationale for this investigation in which we will test the central hypothesis that consumption of supplemental
iron, at levels similar to what ID humans may consume, disrupts copper metabolism with likely
pathological outcomes. Notably, copper deficiency mimics ID, as both conditions cause microcytic,
hypochromic anemia. Lack of adequate iron impairs erythropoiesis in ID, while impaired iron utilization by
developing erythrocytes underlies copper-deficiency anemia. Physicians may recommend higher iron dosing in
patients that are refractory to supplemental iron, thus potentiating the copper deficiency. This investigation
could change the existing paradigm of iron supplementation, with added copper accelerating resolution of the
anemia and also preventing other pathophysiological effects of copper deficiency, including cardiomyopathy,
cognitive dysfunction, and impaired immunity. Three specific aims will be pursued. Aim 1 will define the
minimum amount of supplemental iron that perturbs copper homeostasis in rats and mice of both sexes. Aim 2
will identify the mechanism(s) by which supplemental iron perturbs copper homeostasis, possibly involving
inhibition of intestinal copper transporters. Aim 3 will evaluate the efficacy of Fe + Cu for preventing the copper
depletion associated with high-iron intake in preclinical models of human ID. This investigation may establish
an argument for adding copper to iron supplements. Consuming extra copper should be without negative
physiologic consequence, and could increase the effectiveness of iron supplementation programs, especially
s...

## Key facts

- **NIH application ID:** 10133055
- **Project number:** 5R01DK074867-14
- **Recipient organization:** UNIVERSITY OF FLORIDA
- **Principal Investigator:** James F. Collins
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $475,136
- **Award type:** 5
- **Project period:** 2007-07-01 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10133055

## Citation

> US National Institutes of Health, RePORTER application 10133055, Molecular Mechanisms of Intestinal Metal Ion Transport During Iron Deficiency (5R01DK074867-14). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10133055. Licensed CC0.

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