Effects of Lactobacillus fermentum and iron oxide nanoparticles on iron metabolism in iron deficiency anemia

Iron deficiency anemia (IDA) remains a significant global public health concern, affecting nearly one-third of the population, particularly vulnerable groups such as newborns, children, adolescents, and pregnant women. Conventional iron supplementation strategies, including ferrous sulfate, fumarate, and gluconate, are often hindered by low bioavailability and gastrointestinal side effects, necessitating the exploration of innovative approaches. This study introduces a novel iron-delivery system using iron oxide nanoparticles (IONPs) in combination with the probiotic Lactobacillus fermentum , selected for its acid tolerance and capacity to enhance non-heme iron reduction via organic acid production. It evaluates its efficacy compared with conventional ferrous sulfate in a rat model of IDA. Treatment with L. fermentum and IONPs (NanoProFe) improved iron-related parameters in IDA rats. Hemoglobin concentrations increased from 8.0 g/dL in untreated IDA rats to 14.2 g/dL in the NanoProFe group, compared with 12.0 g/dL in the FeSO 4 group. Compared with untreated IDA rats, NanoProFe increased serum iron and ferritin levels and reduced hepcidin concentrations by 48%, indicating improved iron availability and storage. Notably, histopathological examination revealed reduced hepatic vacuolation and inflammatory infiltrates in NanoProFe-treated rats compared with animals receiving IONPs alone. Given that traditional iron therapies often provoke oxidative stress and gut dysbiosis, the probiotic-IONP combination may support intestinal health while minimizing adverse side effects. These findings indicate that combining L. fermentum with IONPs improves iron status and hematological recovery in experimental IDA and may represent a promising strategy to enhance the efficacy of iron supplementation.