New Directions in Iron Chelating Therapy

Although the iron chelating drug deferroxamine has been available for clinical use for over three decades, it has only gained acceptance as a useful therapeutic agent in the late seventies following the demonstration of its ability to deplete excess iron stores in thalassemic patients. Recognition of the central role of iron in the generation of toxic, oxygen-derived species through the Haber-Weiss reaction (1), documentation of the ability of deferoxamine (DF) to prevent the damage associated with free radical generation in reperfusion injury, and its ability to inhibit the proliferation of malignant cells and protozoa such as the malarial parasite by inactivation of the iron-dependent enzyme ribonucleotide reductase, resulted in a large number of studies exploring the novel therapeutic applications of iron chelating drugs. Some of the information in this field has been reviewed in previous publications (2). The purpose of the present chapter is to summarize the state of the art in the use of DF and other selective iron chelators in conditions unrelated to iron overload.