Iron Physiology and Its Impact on Atopic Diseases: An <scp>EAACI</scp> Taskforce Report

Iron is essential for oxygen transport, energy metabolism, and immune regulation. Yet iron deficiency is the most common micronutrient disorder across all age groups, affecting nearly one quarter of the global population. Iron deficiency triggers nutritional immunity, a host defense mechanism that withholds and redistributes iron, contributing to increased morbidity and mortality. This review outlines normal iron physiology, distribution and absorption pathways and on the consequences of deficiency across body compartments, with particular attention to type 2-driven diseases. Beyond anemia, insufficient iron availability disrupts immune homeostasis by promoting type 2 inflammation, elevating IgE, and activating mast cells and eosinophils. Regulatory macrophages, the central hub of iron cycling, adopt an inflammatory, iron-sequestering state that reinforces malabsorption and redistribution. Epidemiology studies show higher iron-deficiency risk in allergic individuals; low maternal iron or early-life iron predisposes to eczema, wheeze, and asthma, while food-allergen elimination (notably cow's milk) further worsens anemia risk. Clinical evidence indicates that restoring iron status through diet, supplementation, or fortification lowers IgE levels, improves lung function, and alleviates symptoms of rhinitis, urticaria, and asthma. Iron may therefore represent a modifiable determinant of allergic disease development and severity. Integrating iron assessment and nutritional care into allergy management may reduce disease burden and slow the progression of allergic march.

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Publication Details

Journal
Allergy
Published
2026-04-06
DOI
https://doi.org/10.1111/all.70325
Primary Topic
Iron Metabolism and Disorders
Type
article
Field-Weighted Citation Impact
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article

Iron Physiology and Its Impact on Atopic Diseases: An EAACI Taskforce Report

Carina Venter, Nikolaos Douladiris, Εmilia Vassilopoulou, Roberto Berni Canani et al.
Allergy
Iron Metabolism and Disorders
article

Iron Physiology and Its Impact on Atopic Diseases: An EAACI Taskforce Report

Carina Venter, Nikolaos Douladiris, Εmilia Vassilopoulou, Roberto Berni Canani, Pasquale Comberiati, Beatriz Cabanillas, Franziska Roth‐Walter, Frank A. Redegeld, Karin Hufnagl, Holger Garn, Betty C. A. M. van Esch, Gregorio Paolo Milani, Ekaterina Khaleva, Diego Giampietro Peroni, Cristina Gómez‐Casado, Carmen Riggioni, Liam O'Mahony, Daniel Munblit, Ioana Agache
article en

Abstract

Iron is essential for oxygen transport, energy metabolism, and immune regulation. Yet iron deficiency is the most common micronutrient disorder across all age groups, affecting nearly one quarter of the global population. Iron deficiency triggers nutritional immunity, a host defense mechanism that withholds and redistributes iron, contributing to increased morbidity and mortality. This review outlines normal iron physiology, distribution and absorption pathways and on the consequences of deficiency across body compartments, with particular attention to type 2-driven diseases. Beyond anemia, insufficient iron availability disrupts immune homeostasis by promoting type 2 inflammation, elevating IgE, and activating mast cells and eosinophils. Regulatory macrophages, the central hub of iron cycling, adopt an inflammatory, iron-sequestering state that reinforces malabsorption and redistribution. Epidemiology studies show higher iron-deficiency risk in allergic individuals; low maternal iron or early-life iron predisposes to eczema, wheeze, and asthma, while food-allergen elimination (notably cow's milk) further worsens anemia risk. Clinical evidence indicates that restoring iron status through diet, supplementation, or fortification lowers IgE levels, improves lung function, and alleviates symptoms of rhinitis, urticaria, and asthma. Iron may therefore represent a modifiable determinant of allergic disease development and severity. Integrating iron assessment and nutritional care into allergy management may reduce disease burden and slow the progression of allergic march.

Allergy
University of Pisa (IT), Griffith University (AU), Animal Welfare Institute (US), University of Veterinary Medicine Vienna (AT), University of Nicosia (CY), Sechenov University (RU), International Hellenic University (GR), King's College London (GB), University of Toronto (CA), University of Milan (IT), Utrecht University (NL), National and Kapodistrian University of Athens (GR), University College Cork (IE), Florence Nightingale Foundation (GB), University Hospital Southampton NHS Foundation Trust (GB), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Transylvania University of Brașov (RO), Research Institute Hospital 12 de Octubre (ES), Children's Hospital Colorado (US), Instituto de Investigación Biosanitaria de Granada (ES), Federico II University Hospital (IT), Unidades Centrales Científico-Técnicas (ES), NIHR Southampton Biomedical Research Centre (GB), Pharmo Institute (NL), German Center for Lung Research (DE), Universities of Giessen and Marburg Lung Center (DE), SickKids Foundation (CA), APC Microbiome Institute (IE), University of Southampton (GB), University of Colorado Denver (US)
European Academy of Allergy and Clinical Immunology
Zero hunger
Openalex Percentile: Top 25%
Iron Metabolism and Disorders
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