ironchelating

Ironchelating refers to the action of chelating agents that bind iron ions, forming stable complexes that can be excreted from the body. This process reduces free iron that can catalyze harmful oxidative reactions and deposit in tissues. In medicine, ironchelating is most often described in the context of chelation therapy for iron overload.

Mechanism and agents: Iron chelators are multidentate ligands that coordinate iron, typically Fe3+. The resulting metal-ligand complex is water-soluble and can be eliminated, lowering labile iron stores. Clinically used chelators include deferoxamine (administered by injection or infusion), deferasirox (oral, once daily), and deferiprone (oral). Each agent has distinct pharmacokinetics, specificity, and routes of elimination, which influence treatment choice.

Medical use: Ironchelating therapy is employed to treat systemic iron overload resulting from chronic transfusion in conditions such as thalassemia major and certain myelodysplastic syndromes, and in some cases of severe acute iron poisoning. Dosing is guided by measured iron burden, ferritin levels, and patient factors, with regular monitoring to adjust therapy and minimize toxicity.

Safety and monitoring: Side effects are agent-specific. Deferoxamine can cause injection site reactions, hypotension, and, with long-term use, auditory or vision disturbances. Deferasirox may cause renal or hepatic toxicity and gastrointestinal symptoms. Deferiprone carries a risk of neutropenia and agranulocytosis. Ongoing monitoring of ferritin, liver and kidney function, and complete blood counts is standard in ironchelating therapy.