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El-Shafie AS, Osman AI, Al-Hashimi N, Al-Saad K, Al-Ghouti MA, Ibrahim Y, Shibl MF, El-Azazy M. Valorization of olive pruning lignocellulosic residues into carbon dots: A sustainable approach for discrimination of Iron species. Int J Biol Macromol 2025:144628. [PMID: 40414386 DOI: 10.1016/j.ijbiomac.2025.144628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2025] [Revised: 05/18/2025] [Accepted: 05/22/2025] [Indexed: 05/27/2025]
Abstract
Herein, carbon dots (CDs) obtained from biochar of olive tree pruning residues (BC-OTPR) were synthesized at varying pyrolysis temperatures (500, 600, and 700 °C). The spectroscopic features of the CDs were further explored in the context of metal ion detection, specifically focusing on the discrimination of iron species. Significant fluorescence quenching upon interaction with iron (III), compared to iron (II) and other metal ions, was observed, indicating their potential as sensitive probes. In the presence of hydrogen peroxide and via the Fenton reaction, iron (II) was quantitatively oxidized into iron (III) - the determinable form, allowing for iron speciation. Synthesized CDs were analyzed using UV-Vis spectroscopy. Transmission Electron Microscopy (TEM) images revealed the uniform spherical morphology. Using the FT-IR analysis, transformation of hemicellulose and lignin present in the BC-OTPR into CDs with unique functionalities was corroborated. The CDs exhibited excitation-dependent fluorescence behavior, showcasing their potential for spectroscopic applications. Regression modeling was employed to investigate variables influencing iron detection. Notably, the CDs displayed linear behavior spanning over a range of 1.186 μM - 7.984 μM with a low limit of detection (LOD) of 0.5 μM of iron (III). Validation of precision and accuracy confirmed CDs' efficacy for analyzing food supplements and water samples.
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Affiliation(s)
- Ahmed S El-Shafie
- Department of Chemistry and Earth Sciences, College of Arts and Sciences, Qatar University, Doha 2713, Qatar.
| | - Ahmed I Osman
- School of Chemistry and Chemical Engineering, Queen's University Belfast, Belfast BT9 5AG, United Kingdom of Great Britain and Northern Ireland.
| | - Nessreen Al-Hashimi
- Department of Chemistry and Earth Sciences, College of Arts and Sciences, Qatar University, Doha 2713, Qatar
| | - Khalid Al-Saad
- Department of Chemistry and Earth Sciences, College of Arts and Sciences, Qatar University, Doha 2713, Qatar
| | - Mohammad A Al-Ghouti
- Environmental Sciences Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha 2713, Qatar
| | - Yassmin Ibrahim
- Center for Advanced Materials, Qatar University, Doha 2713, Qatar
| | - Mohamed F Shibl
- Chemistry Department, Faculty of Sciences, Cairo University, Giza 12613, Cairo, Egypt
| | - Marwa El-Azazy
- Department of Chemistry and Earth Sciences, College of Arts and Sciences, Qatar University, Doha 2713, Qatar.
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2
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Trivedi S, Kevlani V, Shah S. Ferrous ascorbate non-effervescent floating mini-caplets as an oral iron supplement. Drug Deliv Transl Res 2025; 15:1554-1566. [PMID: 39133426 DOI: 10.1007/s13346-024-01691-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2024] [Indexed: 08/13/2024]
Abstract
PURPOSE This research aimed to develop non-effervescent floating mini-caplets of Ferrous Ascorbate (FA) using low-density polymers to overcome the problems of poor bioavailability associated with immediate-release iron products. Methods: The excipients and method (melt granulation) were selected based on pre-and post-compression parameters in trial batches. The formulation was optimized by a full factorial 32 experimental design. An optimized formulation was evaluated for drug release kinetic, accelerated stability study, and in vivo study in healthy adult New Zealand female rabbits. Results: The optimized formulation F6 mini-caplets (42.5% FA, 45% Glyceryl palmitostearate as Precirol, 10% polyvinyl pyrrolidone K-30, and 2.5% lactose) were found to have instant floating and 12 h floating duration in 0.1N Hydrochloric acid (HCl) dissolution medium. In vitro drug release (diffusion mechanism) at 1 h and 5 h was 30-35% and 65-70%, respectively. It was found stable for three months under an accelerated stability study. In vivo study showed significantly increased serum iron levels and decreased unsaturated iron binding capacity (UIBC) in the test group (optimized formulation) compared to control and standard (immediate-release iron). Conclusion: Based on the in vitro and in vivo results, we conclude that non-effervescent floating FA mini-caplets have higher bioavailability compared to immediate release FA, which may be attributed to prolonged iron release at its absorption site due to their retention in the gastric region. Hence, non-effervescent floating FA mini-caplets may act as a potential approach for iron deficiency.
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Affiliation(s)
- Shital Trivedi
- Research Scholar, Gujarat Technological University, Ahmedabad, 382424, Gujarat, India
- Department of Pharmaceutical Technology, L. J. Institute of Pharmacy, L J University, Ahmedabad, Gujarat, India
| | - Vijay Kevlani
- Department of Pharmacology, L. J. Institute of Pharmacy, L J University, Ahmedabad, Gujarat, India
| | - Shreeraj Shah
- Department of Pharmaceutical Technology, L. J. Institute of Pharmacy, L J University, Ahmedabad, Gujarat, India.
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Harrabi MA, Fendri T, Chaari F, Ayed R, Mezghani I, Kallel C, Rebai H, Turki M, Ayadi F, Sahli S. Eight weeks of oral iron supplementation improves postural control in young women with iron deficiency anemia. Eur J Clin Nutr 2025; 79:156-160. [PMID: 39414981 DOI: 10.1038/s41430-024-01522-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 10/08/2024] [Accepted: 10/09/2024] [Indexed: 10/18/2024]
Abstract
OBJECTIVE This study aimed to explore the effect of 8-week oral supplementation on postural control in young women with iron deficiency anemia (IDA). METHODS This study involved 15 women with IDA who received 160 mg of elemental iron daily in the form of dried ferrous sulfate capsules (80 mg twice daily) taken in two divided doses for 8 weeks. The mean velocity of oscillations of the center of pressure (CoPv) was recorded to evaluate postural control pre- and post-supplementation. In addition, simple reaction time (SRT) and weight discrimination tests were performed to assess attentional capacity and proprioceptive acuity, respectively. RESULTS This study revealed significant increases (P < 0.001, mean difference = 1.83, 95% CI: -17.25; -9.42) in proprioceptive acuity values, as well as decreases in CoPv [firm (EO (P < 0.01, mean difference = 0.52, 95% CI: 0.69; 2.92), EC (P < 0.05, mean difference = 0.75, 95% CI: 0.24; 3.45)) and foam (EO (P < 0.001, mean difference = 0.64, 95% CI: 1.71; 4.44) ; EC (P < 0.001, mean difference = 1.04, 95% CI: 3.51; 7.97))] and SRT (P < 0.001, mean difference = 59.31, 95% CI: 103.02; 168.71) values post-supplementation compared to pre-supplementation. CONCLUSION This study showed significant improvements in postural control in young women with IDA after 8 weeks of oral iron supplementation. These improvements were probably related to the enhanced bioavailability of iron, which may have influenced neural processes inducing improvements in attention capacity and proprioceptive acuity.
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Affiliation(s)
- Mohamed Achraf Harrabi
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Sfax, Tunisia.
| | - Thouraya Fendri
- Sport, Physical Activity, Rehabilitation and Movement for Performance and Health (SAPRéM), Université d'Orléans, Orléans, France
- Complexity, Innovations, Motor and Sports Activities (CIAMS), Université d'Orléans, Orléans, France
| | - Fatma Chaari
- Laboratory 'Movement, Interactions, Performance', Faculty of Sciences and Technologies, Le Mans University, Le Mans, France
| | - Rahma Ayed
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
- Laboratory of Biochemistry, Habib Bourguiba University Hospital, University of Sfax, 3000, Sfax, Tunisia
| | - Ines Mezghani
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
- Laboratory of Biochemistry, Hedi Chaker University Hospital, University of Sfax, 3000, Sfax, Tunisia
| | - Choumous Kallel
- Laboratory of Hematology, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Haithem Rebai
- Sports Performance Optimization (LR09SEP01), National Center of Medecine and Science in Sports (CNMSS), Tunis, Tunisia
| | - Mouna Turki
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
- Laboratory of Biochemistry, Hedi Chaker University Hospital, University of Sfax, 3000, Sfax, Tunisia
| | - Fatma Ayadi
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
- Laboratory of Biochemistry, Habib Bourguiba University Hospital, University of Sfax, 3000, Sfax, Tunisia
| | - Sonia Sahli
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Sfax, Tunisia
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Gremme A, Safa Flaih ZAT, Scholz J, Gerisch E, Thiel A, McColl G, Hayen H, Michalke B, Bornhorst J. Is Ferric the Same as Ferrous? Effect of Nutritionally Relevant Iron Species in C. elegans: Bioavailability, Iron Homeostasis, Oxidative Stress, and Cell Death. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2025; 73:3714-3723. [PMID: 39899691 DOI: 10.1021/acs.jafc.4c10463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2025]
Abstract
Iron (Fe) is present in foods and food supplements in a wide variety of Fe species. Caution needs to be paid in the case of overdosing on this essential trace element as adverse effects like neurodegenerative diseases are associated with increased iron levels in the brain. However, knowledge regarding the species-specific effects of nutritionally relevant Fe species is limited. Therefore, we treated the nematode Caenorhabditis elegans (C. elegans) with an overdose of the Fe species iron(III) ammonium citrate (FAC), iron(II) gluconate (FeGlu), and iron(II) chloride (FeCl2) for 5 and 24 h. While the bioavailability of Fe was highest with FeCl2 and lowest with FAC, the effects on tested endpoints, such as superoxide dismutase activity, translocation of the transcription factor daf-16 (human FOXO3), mitochondrial reactive oxygen and nitrogen species, and apoptotic cells were similar. This study provides further insights into Fe-species-specific effects on genes related to Fe homeostasis of C. elegans by studying gene expression and investigating C. elegans mutants lacking smf-3, ftn-1, ftn-2, dcytb (f55h2.5), and cp (f21d5.3). Thus, these findings underline the significance of the oxidation state and ligand of Fe species with respect to bioavailability while also identifying the key genes involved in Fe homeostasis in C. elegans.
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Affiliation(s)
- Anna Gremme
- Food Chemistry with focus on toxicology, Faculty of Mathematics and Natural Science, University of Wuppertal, Wuppertal 42119, Germany
| | - Zainab Al-Timimi Safa Flaih
- Food Chemistry with focus on toxicology, Faculty of Mathematics and Natural Science, University of Wuppertal, Wuppertal 42119, Germany
| | - Johannes Scholz
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster 48149, Germany
| | - Emely Gerisch
- Food Chemistry with focus on toxicology, Faculty of Mathematics and Natural Science, University of Wuppertal, Wuppertal 42119, Germany
| | - Alicia Thiel
- Food Chemistry with focus on toxicology, Faculty of Mathematics and Natural Science, University of Wuppertal, Wuppertal 42119, Germany
| | - Gawain McColl
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Heiko Hayen
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster 48149, Germany
| | - Bernhard Michalke
- Helmholtz Zentrum München, Research Unit Analytical BioGeoChemistry, Neuherberg 85764, Germany
| | - Julia Bornhorst
- Food Chemistry with focus on toxicology, Faculty of Mathematics and Natural Science, University of Wuppertal, Wuppertal 42119, Germany
- TraceAge - DFG Research Unit on Interactions of Essential Trace Elements on Healthy and Diseased Elderly (FOR 2558), Berlin-Potsdam-Jena-Wuppertal 14558 Germany
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5
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Liu C, Liu Z, Dong Z, Liu S, Kan H, Zhang S. Multifaceted interplays between the essential players and lipid peroxidation in ferroptosis. J Genet Genomics 2025:S1673-8527(25)00024-4. [PMID: 39862922 DOI: 10.1016/j.jgg.2025.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Revised: 01/17/2025] [Accepted: 01/17/2025] [Indexed: 01/27/2025]
Abstract
Ferroptosis, a type of programmed cell death, represents a distinct paradigm in cell biology. It is characterized by the iron-dependent accumulation of reactive oxygen species, which induce lipid peroxidation (LPO), and is orchestrated by the interplay between iron, lipid peroxides, and glutathione. In this review, we emphasize the frequently overlooked role of iron in LPO beyond the classical iron-driven Fenton reaction in several crucial processes that regulate cellular iron homeostasis, including iron intake and export as well as ferritinophagy, and the emerging roles of endoplasmic reticulum-resident flavoprotein oxidoreductases, especially P450 oxidoreductases, in modulating LPO. We summarize how various types of fatty acids (FAs), including saturated, monounsaturated, and polyunsaturated FAs, differentially influence ferroptosis when incorporated into phospholipids. Furthermore, we highlight the therapeutic potential of targeting LPO to mitigate ferroptosis and discuss the regulatory mechanisms of endogenous lipophilic radical-trapping antioxidants that confer resistance to ferroptosis, shedding light on therapeutic avenues for ferroptosis-associated diseases.
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Affiliation(s)
- Conghe Liu
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, China
| | - Zhihao Liu
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, China; School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong 250117, China
| | - Zheng Dong
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, China
| | - Sijin Liu
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China
| | - Shuping Zhang
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, China; Biomedical Sciences College & Shandong Medicinal Biotechnology Centre, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, China.
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6
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Kaberi-Otarod J, Still CD, Wood GC, Benotti PN. Iron Treatment in Patients with Iron Deficiency Before and After Metabolic and Bariatric Surgery: A Narrative Review. Nutrients 2024; 16:3350. [PMID: 39408317 PMCID: PMC11478352 DOI: 10.3390/nu16193350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Revised: 09/27/2024] [Accepted: 09/30/2024] [Indexed: 10/20/2024] Open
Abstract
Iron is an essential nutrient in living organisms with multiple vital functions. Iron deficiency (ID) can cause long term health consequences beyond iron deficiency anemia (IDA). The high prevalence of ID and its long-term effects in patients with obesity and after metabolic and bariatric surgery (MBS) is recognized. Nevertheless, there is limited knowledge of the optimal route or dose for treatment of patients with obesity and post-MBS, and an evidence-based universal guideline for prevention and treatment of ID in short- and long-term post-MBS (PMBS) is not yet available. ID in the general population is currently treated with oral or parenteral iron, where oral iron treatment is considered the preferred option with parenteral iron as a second-line treatment in case there is intolerance or lack of response to oral iron. In patients with obesity with chronic low-grade inflammation and PMBS patients with altered gut anatomy and function, there are also alterations in the bioavailability and higher risks of side effects of available oral irons. The conclusions of current studies exploring effective treatment of iron deficiency in this population have been inconsistent and further well-planned randomized and prospective studies are needed. This is a narrative review of the literature on the available treatment options and strategies for treatment of ID in PMBS patients to recognize the knowledge gaps and provides topics of future research.
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Affiliation(s)
- Jila Kaberi-Otarod
- Department of Nutrition and Weight Management, Geisinger Health System Northeast, Scranton, PA 18503, USA
| | - Christopher D. Still
- The Center for Obesity and Metabolic Research, Geisinger Obesity Institute, Danville, PA 17821, USA; (C.D.S.); (G.C.W.); (P.N.B.)
| | - G. Craig Wood
- The Center for Obesity and Metabolic Research, Geisinger Obesity Institute, Danville, PA 17821, USA; (C.D.S.); (G.C.W.); (P.N.B.)
| | - Peter N. Benotti
- The Center for Obesity and Metabolic Research, Geisinger Obesity Institute, Danville, PA 17821, USA; (C.D.S.); (G.C.W.); (P.N.B.)
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7
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Pantopoulos K. Oral iron supplementation: new formulations, old questions. Haematologica 2024; 109:2790-2801. [PMID: 38618666 PMCID: PMC11367235 DOI: 10.3324/haematol.2024.284967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Indexed: 04/16/2024] Open
Abstract
Iron-deficiency anemia and pre-anemic iron deficiency are the most frequent pathologies. The first line of treatment involves oral iron supplementation. The simplest, least expensive, and most commonly prescribed drug is ferrous sulfate, while other ferrous salts and ferric complexes with polysaccharides or succinylated milk proteins are also widely used. In recent years, novel iron formulations have been developed, such as the lipophilic iron donor ferric maltol, or nanoparticle encapsulated sucrosomial® iron. Oral iron supplementation is usually efficacious in correcting iron-deficiency anemia and replenishing iron stores but causes gastrointestinal side effects that reduce compliance. When oral iron supplementation is contraindicated, intravenous iron therapy can rapidly achieve therapeutic targets without gastrointestinal complications. Herein, we critically review literature on relative efficacy and tolerability of currently available oral iron supplements, and summarize recent data on optimal dosage and frequency.
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Affiliation(s)
- Kostas Pantopoulos
- Lady Davis Institute for Medical Research, Jewish General Hospital, and Department of Medicine, McGill University, Montreal, Quebec.
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8
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Sharma R, Bisht P, Kesharwani A, Murti K, Kumar N. Epigenetic modifications in Parkinson's disease: A critical review. Eur J Pharmacol 2024; 975:176641. [PMID: 38754537 DOI: 10.1016/j.ejphar.2024.176641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/13/2024] [Accepted: 05/13/2024] [Indexed: 05/18/2024]
Abstract
Parkinson's Disease (PD) is a progressive neurodegenerative disorder expected to increase by over 50% by 2030 due to increasing life expectancy. The disease's hallmarks include slow movement, tremors, and postural instability. Impaired protein processing is a major factor in the pathophysiology of PD, leading to the buildup of aberrant protein aggregates, particularly misfolded α-synuclein, also known as Lewy bodies. These Lewy bodies lead to inflammation and further death of dopaminergic neurons, leading to imbalances in excitatory and inhibitory neurotransmitters, causing excessive uncontrollable movements called dyskinesias. It was previously suggested that a complex interplay involving hereditary and environmental variables causes the specific death of neurons in PD; however, the exact mechanism of the association involving the two primary modifiers is yet unknown. An increasing amount of research points to the involvement of epigenetics in the onset and course of several neurological conditions, such as PD. DNA methylation, post-modifications of histones, and non-coding RNAs are the primary examples of epigenetic alterations, that is defined as alterations to the expression of genes and functioning without modifications in DNA sequence. Epigenetic modifications play a significant role in the development of PD, with genes such as Parkin, PTEN-induced kinase 1 (PINK1), DJ1, Leucine-Rich Repeat Kinase 2 (LRRK2), and alpha-synuclein associated with the disease. The aberrant epigenetic changes implicated in the pathophysiology of PD and their impact on the design of novel therapeutic approaches are the primary focus of this review.
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Affiliation(s)
- Ravikant Sharma
- Research Unit of Biomedicine and Internal Medicine, Faculty of Medicine, University of Oulu, Aapistie 5, 90220, Oulu, Finland
| | - Priya Bisht
- Department of Pharmacology and Toxicology, National Institution of Pharmaceutical Education and Research, Hajipur, Vaishali, 844102, Bihar, India
| | - Anuradha Kesharwani
- Department of Pharmacology and Toxicology, National Institution of Pharmaceutical Education and Research, Hajipur, Vaishali, 844102, Bihar, India
| | - Krishna Murti
- Department of Pharmacy Practice, National Institution of Pharmaceutical Education and Research, Hajipur, Vaishali, 844102, Bihar, India
| | - Nitesh Kumar
- Department of Pharmacology and Toxicology, National Institution of Pharmaceutical Education and Research, Hajipur, Vaishali, 844102, Bihar, India.
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9
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Jyothi GS, Shelatkar R, Kalavathy HR, Vaidya VG, Sisode M, Ganu G. A clinical study evaluating low dose ferrous fumarate vs. standard iron supplements in iron-deficient non-anemic to mild anemic adults. Sci Rep 2024; 14:15674. [PMID: 38977742 PMCID: PMC11231206 DOI: 10.1038/s41598-024-65878-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 06/25/2024] [Indexed: 07/10/2024] Open
Abstract
Our study aims to validate safety and efficacy of Feroglobin capsule compared with different iron supplementations in adult subjects diagnosed with non-anemic to mild anemic iron deficiency and fatigue. Enrolled 302 participants diagnosed with non-anemic to mild anemic iron deficiency and fatigue. Group A (n = 147) received Feroglobin, Group B (n = 146) received standard of care [Haem Up Gems capsules (Ferrous fumarate) or Fericip tablets (Ferrous ascorbate)]. 293 subjects completed the study with follow-up visits on days 30, 60, and 90. Feroglobin treatment significantly increased hemoglobin levels from mean 12.43 g/dl to 13.24 g/dl in 90 days. Ferritin levels improved significantly by 442.87% compared to the standard care's 256.67%. Fatigue scale scores reduced by 47.51%, and all presenting health complaints resolved completely. Gastrointestinal symptoms observed were similar in both the groups. Both groups exhibited moderate treatment adherence. Quality of life improved in pain and general health domains, exhibiting a good tolerability. Adverse events were unrelated to the investigational products. Feroglobin serves as an efficacious therapeutic alternative for improving hemoglobin, ferritin, and reducing fatigue with low doses compared to standard of care. However, longer-term effects of low-dose require further investigations in different target groups.
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Affiliation(s)
- G S Jyothi
- Ramaiah Medical College, Bengaluru, Karnataka, 560054, India.
| | | | - H R Kalavathy
- Kala Hospital and Clinical Laboratory, 1105, KN Extension, 5Th Cross, Triveni Road, Yeswanthpur, Bengaluru, Karnataka, 560022, India
| | - V G Vaidya
- Lokmanya Medical Research Centre and Hospital, Fourth Floor OPD 401314 B Telco Road, Chinchwad, Pune, Maharashtra, India
| | - Manjit Sisode
- Janseva Hospital, 2Nd Floor, Datta Mandir Chowk, Deopur, Dhule, India
| | - Gayatri Ganu
- Mprex Healthcare Pvt. Ltd., Office Number 501, 514 Crossroads, Bhumkar Square, Wakad, Pune, India
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10
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Csulak E, Gellért B, Hritz I, Miheller P, Farkas P, Kovács G, Szabó A, Ács N, Becker D, Sydó N, Merkely B. [Semmelweis University Iron Board - Consensus statement of iron treatment]. Orv Hetil 2024; 165:1027-1038. [PMID: 39002116 DOI: 10.1556/650.2024.33078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 05/08/2024] [Indexed: 07/15/2024]
Abstract
A vashiány a leggyakoribb nyomelemhiány a világon, ezáltal jelentős globális
egészségi problémát okoz mind a felnőttek, mind a gyermekek egészségügyi
ellátásában. A vashiány számos társbetegséggel jár együtt, és jelentősen
befolyásolja az életminőséget. Az anaemia kialakulása előtti felismerésével a
tünetek és az életminőség javítható már korai stádiumban. Diagnosztizálásában és
kezelésében számos orvosi terület érintett, ennek ellenére egyik diszciplína sem
vállalja igazán magára a feladatot. A jelen konszenzusdokumentum célja egy
egységes, diagnosztikus és terápiás útmutató létrehozása a vashiány miatt
leginkább érintett orvosi területeken. A konszenzusos dokumentumot hematológiai,
gasztroenterológiai, szülészet-nőgyógyászati, kardiológiai, gyermekgyógyászati
és sportorvostani szakterületen jártas orvosok dolgozták ki, akik a Semmelweis
Egyetem Iron Board tagjai. A konszenzusdokumentum szakterületenként tartalmazza
a legfrissebb szakmai ajánlást. A vashiánybetegség különböző stádiumainak
diagnosztikájához a vérképnek és a vasanyagcserét mutató paramétereknek
(szérumvas, transzferrin, transzferrinszaturáció, ferritin) a vizsgálata
szükséges. Az anaemia diagnózisához szükséges hemoglobinszint egyértelműen
meghatározott, mely minden felnőtt betegcsoportra egyaránt érvényes: férfiaknál
<130 g/l, nőknél <120 g/l, míg gyermekeknél életkortól függően változik.
Az elsődleges cél a vashiánybetegség okának megállapítása és annak célzott
kezelése. Az orális vaskezelés az első vonalbeli terápia a legtöbb esetben, mely
biztonságos és hatékony a tünetes vagy anaemia kialakulására nagy kockázatú
betegek esetén. Vas(II)-sók alkalmazásakor a készítmény másnaponkénti adagolása
javítja az együttműködést, a tolerálhatóságot és a felszívódást. A
vas(III)-hidroxid-polimaltóz előnye, hogy nem szükséges éhgyomorra bevenni,
emellett már kora terhességben és gyerekeknél is biztonságosan alkalmazható. A
C-vitamin használata a felszívódás növelése érdekében a legújabb klinikai
vizsgálatok szerint nem jár előnnyel. Intravénás vaspótlás javasolt, ha a
vasháztartás gyors rendezése szükséges, ha az orális kezelés nem tolerálható
vagy nagy valószínűséggel hatástalan lesz, továbbá elsősorban pangásos
szívelégtelenség, várandósság, gyulladásos bélbetegség, felszívódási zavar és
preoperatív állapot esetén. Orv Hetil. 2024; 165(27): 1027–1038.
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Affiliation(s)
- Emese Csulak
- 3 Semmelweis Egyetem, Általános Orvostudományi Kar, Városmajori Szív- és Érgyógyászati Klinika Budapest, Városmajor u. 68.,1122 Magyarország
- 5 Semmelweis Egyetem, Sportorvostan Tanszék Budapest Magyarország
| | - Bálint Gellért
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Sebészeti, Transzplantációs és Gasztroenterológiai Klinika Budapest Magyarország
| | - István Hritz
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Sebészeti, Transzplantációs és Gasztroenterológiai Klinika Budapest Magyarország
| | - Pál Miheller
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Sebészeti, Transzplantációs és Gasztroenterológiai Klinika Budapest Magyarország
| | - Péter Farkas
- 4 Semmelweis Egyetem, Általános Orvostudományi Kar, Belgyógyászati és Hematológiai Klinika Budapest Magyarország
| | - Gábor Kovács
- 6 Semmelweis Egyetem, Általános Orvostudományi Kar, Gyermekgyógyászati Klinika Budapest Magyarország
| | - Attila Szabó
- 6 Semmelweis Egyetem, Általános Orvostudományi Kar, Gyermekgyógyászati Klinika Budapest Magyarország
| | - Nándor Ács
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika Budapest Magyarország
| | - Dávid Becker
- 3 Semmelweis Egyetem, Általános Orvostudományi Kar, Városmajori Szív- és Érgyógyászati Klinika Budapest, Városmajor u. 68.,1122 Magyarország
| | - Nóra Sydó
- 3 Semmelweis Egyetem, Általános Orvostudományi Kar, Városmajori Szív- és Érgyógyászati Klinika Budapest, Városmajor u. 68.,1122 Magyarország
- 5 Semmelweis Egyetem, Sportorvostan Tanszék Budapest Magyarország
| | - Béla Merkely
- 3 Semmelweis Egyetem, Általános Orvostudományi Kar, Városmajori Szív- és Érgyógyászati Klinika Budapest, Városmajor u. 68.,1122 Magyarország
- 5 Semmelweis Egyetem, Sportorvostan Tanszék Budapest Magyarország
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11
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Alenkina IV, Oshtrakh MI. Control of the Iron State in Pharmaceuticals Used for Treatment and Prevention of Iron Deficiency Using Mössbauer Spectroscopy. J Pharm Sci 2024; 113:1426-1454. [PMID: 38423387 DOI: 10.1016/j.xphs.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 03/02/2024]
Abstract
Various iron-containing medicaments, vitamins and dietary supplements are used or developed for treatment and prevention of the iron deficiency anemia which is very dangerous for human and may cause various disorders. From the other hand, blood losses, iron poor diet, microelements (co-factors) deficiency, metabolic failures, absorption problems, etc. can change the iron status and affect the health. These pharmaceuticals contain iron compounds in the ferrous and ferric states. It is known that ferrous salts are more suitable for the intestinal intake than ferric ones. On the other hand, pharmaceutically important ferritin analogues contain ferric hydrous oxides and appear to be effective for both injections and peroral administration. 57Fe Mössbauer spectroscopy is a unique physical technique which allows one to study various iron-containing materials including pharmaceuticals. Therefore, this technique was applied to study iron-containing pharmaceuticals for the analysis of the iron state, identification of ferric and ferrous compounds, revealing some structural peculiarities and for detection of aging processes in relation to the iron compounds. This review considers the main results of a long experience in the study of iron-containing pharmaceuticals by Mössbauer spectroscopy with critical analysis that may be useful for pharmacists, biochemists, biophysicists, and physicians.
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Affiliation(s)
- Irina V Alenkina
- Department of Experimental Physics, Institute of Physics and Technology, Ural Federal University, Ekaterinburg, 620002, Russian Federation
| | - Michael I Oshtrakh
- Department of Experimental Physics, Institute of Physics and Technology, Ural Federal University, Ekaterinburg, 620002, Russian Federation.
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12
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Kaur T, Upadhyay J, Nandave M, Alsayari A, Alshehri SA, Pukale S, Wahab S, Ahmad W, Rashid S, Ansari MN. Exploring progress in iron supplement formulation approaches for treating iron deficiency anemia through bibliometric and thematic analysis. Heliyon 2024; 10:e29058. [PMID: 38623202 PMCID: PMC11016621 DOI: 10.1016/j.heliyon.2024.e29058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/04/2024] [Accepted: 03/28/2024] [Indexed: 04/17/2024] Open
Abstract
Anemia is a severe health issue that affects around one-third of the global population. Therefore, the present study aims to conduct a bibliometric analysis to investigate the research trends regarding advancements on iron formulations in treating iron deficiency anemia via oral or parenteral route. This study adopts thematic and bibliometric methods on existing research on novel iron formulations. It also provides perspective into the existing understanding on treatment strategies for iron deficiency anemia. This study is conducted on 543 papers on various ferrous and ferric formulations used in the treatment of iron deficiency anemia. The study period is from 1977 to 2022, and the papers are identified from the Scopus database. The bibliometric analysis was carried out using the R tool's Bibliometrix package. The study discusses performance analysis, including annual publications, geographic analysis, relevant affiliations, journal analysis, and citation analysis. In addition, the conceptual structure, including the co-occurrence network, thematic map, thematic evolution, intellectual structure highlighting co-citation analysis, and social structure depicting the collaboration network and collaboration world map, are presented. The results showed increased research on formulation strategies for the treatment of iron deficiency anemia from 2010 onwards. The top 5 contributing countries are the USA, Italy, India, Germany, and the UK, and peer-reviewed journals from the area of nutrition. The most trending areas of study are iron deficiency anemia in pregnancy, chronic kidney diseases, inflammatory bowel diseases, and various intravenous formulations used in its treatment. The authors from Europe collaborate the most with authors from other countries. The study concludes that a safer and more effective iron formulation is needed to reduce the prevalence of anemia. The findings of the study are helpful in advancing research on innovative formulations for treating iron deficiency anemia. The insights from the study are helpful to policymakers in designing specific health policies and investing more in research and development of novel formulations for the treatment of iron deficiency anemia.
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Affiliation(s)
- Tarnjot Kaur
- Department of Pharmaceutical Sciences, School of Health Sciences and Technology, UPES, Bidholi Campus, Dehradun 248007, Uttarakhand, India
| | - Jyoti Upadhyay
- Department of Pharmaceutical Sciences, School of Health Sciences and Technology, UPES, Bidholi Campus, Dehradun 248007, Uttarakhand, India
| | - Mukesh Nandave
- Department of Pharmacology, Delhi Pharmaceutical Sciences and Research University New Delhi, 110017, India
| | - Abdulrhman Alsayari
- Department of Pharmacognosy, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia
| | - Saad Ali Alshehri
- Department of Pharmacognosy, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia
| | - Sudeep Pukale
- Lupin Research Park, Nande, Maharashtra 412115, India
| | - Shadma Wahab
- Department of Pharmacognosy, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia
| | - Wasim Ahmad
- Department of Pharmacy, Mohammed Al-Mana College for Medical Sciences, Dammam 34222, Saudi Arabia
| | - Summya Rashid
- Department of Pharmacology & Toxicology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Mohd Nazam Ansari
- Department of Pharmacology & Toxicology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
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13
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Loechl CU, Datta-Mitra A, Fenlason L, Green R, Hackl L, Itzkowitz L, Koso-Thomas M, Moorthy D, Owino VO, Pachón H, Stoffel N, Zimmerman MB, Raiten DJ. Approaches to Address the Anemia Challenge. J Nutr 2023; 153 Suppl 1:S42-S59. [PMID: 37714779 PMCID: PMC10797550 DOI: 10.1016/j.tjnut.2023.07.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 07/21/2023] [Accepted: 07/31/2023] [Indexed: 09/17/2023] Open
Abstract
Anemia is a multifactorial condition; approaches to address it must recognize that the causal factors represent an ecology consisting of internal (biology, genetics, and health) and external (social/behavioral/demographic and physical) environments. In this paper, we present an approach for selecting interventions, followed by a description of key issues related to the multiple available interventions for prevention and reduction of anemia. We address interventions for anemia using the following 2 main categories: 1) those that address nutrients alone, and, 2) those that address nonnutritional causes of anemia. The emphasis will be on interventions of public health relevance, but we also consider the clinical context. We also focus on interventions at different stages of the life course, with a particular focus on women of reproductive age and preschool-age children, and present evidence on various factors to consider when selecting an intervention-inflammation, genetic mutations, nutrient delivery, bioavailability, and safety. Each section on an intervention domain concludes with a brief discussion of key research areas.
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Affiliation(s)
- Cornelia U Loechl
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Ananya Datta-Mitra
- Department of Pathology and Laboratory Medicine, University of California, Davis, Davis, CA, United States
| | - Lindy Fenlason
- Bureau for Global Health, USAID, Washington, DC, United States
| | - Ralph Green
- Department of Pathology and Laboratory Medicine, University of California, Davis, Davis, CA, United States
| | - Laura Hackl
- USAID Advancing Nutrition, John Snow Inc., Arlington, VA, United States
| | - Laura Itzkowitz
- Bureau for Global Health, USAID, Washington, DC, United States
| | - Marion Koso-Thomas
- Eunice Kennedy Shriver National Institute of Child Health and Development, National Institutes of Health, Bethesda, MD, Unites States
| | - Denish Moorthy
- USAID Advancing Nutrition, John Snow Inc., Arlington, VA, United States.
| | | | - Helena Pachón
- Food Fortification Initiative, Emory University, Atlanta, GA, United States
| | - Nicole Stoffel
- Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zurich, Zu¨rich, Switzerland; MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Michael B Zimmerman
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Daniel J Raiten
- Eunice Kennedy Shriver National Institute of Child Health and Development, National Institutes of Health, Bethesda, MD, Unites States
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14
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Kardasis W, Naquin ER, Garg R, Arun T, Gopianand JS, Karmakar E, Gnana-Prakasam JP. The IRONy in Athletic Performance. Nutrients 2023; 15:4945. [PMID: 38068803 PMCID: PMC10708480 DOI: 10.3390/nu15234945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/21/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
Iron is an essential micronutrient for athletes, intricately linked to their performance, by regulating cellular respiration and metabolism. Impaired iron levels in the body can significantly hinder athletic performance. The increased demand for iron due to exercise, coupled with potential dietary iron insufficiencies, particularly among endurance athletes, amplifies the risk of iron deficiency. Moreover, prolonged exercise can impact iron absorption, utilization, storage, and overall iron concentrations in an athlete. On the contrary, iron overload may initially lead to enhanced performance; however, chronic excess iron intake or underlying genetic conditions can lead to detrimental health consequences and may negatively impact athletic performance. Excess iron induces oxidative damage, not only compromising muscle function and recovery, but also affecting various tissues and organs in the body. This narrative review delineates the complex relationship between exercise and iron metabolism, and its profound effects on athletic performance. The article also provides guidance on managing iron intake through dietary adjustments, oral iron supplementation for performance enhancement in cases of deficiency, and strategies for addressing iron overload in athletes. Current research is focused on augmenting iron absorption by standardizing the route of administration while minimizing side effects. Additionally, there is ongoing work to identify inhibitors and activators that affect iron absorption, aiming to optimize the body's iron levels from dietary sources, supplements, and chelators. In summary, by refining the athletic diet, considering the timing and dosage of iron supplements for deficiency, and implementing chelation therapies for iron overload, we can effectively enhance athletic performance and overall well-being.
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Affiliation(s)
| | | | | | | | | | - Eshani Karmakar
- School of Medicine, Saint Louis University, St. Louis, MO 63104, USA; (W.K.); (E.R.N.); (R.G.); (T.A.); (J.S.G.)
| | - Jaya P. Gnana-Prakasam
- School of Medicine, Saint Louis University, St. Louis, MO 63104, USA; (W.K.); (E.R.N.); (R.G.); (T.A.); (J.S.G.)
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15
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de Romaña DL, Mildon A, Golan J, Jefferds MED, Rogers LM, Arabi M. Review of intervention products for use in the prevention and control of anemia. Ann N Y Acad Sci 2023; 1529:42-60. [PMID: 37688369 PMCID: PMC10876383 DOI: 10.1111/nyas.15062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Anemia remains a major public health problem, especially in low- and middle-income countries. The World Health Organization recommends several interventions to prevent and manage anemia in vulnerable population groups, including young children, menstruating adolescent girls and women, and pregnant and postpartum women. Daily iron supplementation reduces the risk of anemia in infants, children, and pregnant women, and intermittent iron supplementation reduces anemia risk in menstruating girls and women. Micronutrient powders reduce the risk of anemia in children. Fortifying wheat flour with iron reduces the risk of anemia in the overall population, whereas the effect of fortifying maize flour and rice is still uncertain. Regarding non-nutrition-related interventions, malaria treatment and deworming have been reported to decrease anemia prevalence. Promising interventions to prevent anemia include vitamin A supplementation, multiple micronutrient supplementation for pregnant women, small-quantity lipid-based supplements, and fortification of salt with iodine and iron. Future research could address the efficacy and safety of different iron supplementation formulations, identify the most bioavailable form of iron for fortification, examine adherence to supplementation regimens and fortification standards, and investigate the effectiveness of integrating micronutrient, helminth, and malaria control programs.
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Affiliation(s)
| | - Alison Mildon
- Global Technical Services, Nutrition International, Ottawa, Ontario, Canada
| | - Jenna Golan
- Global Technical Services, Nutrition International, Ottawa, Ontario, Canada
| | | | - Lisa M. Rogers
- Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland
| | - Mandana Arabi
- Global Technical Services, Nutrition International, Ottawa, Ontario, Canada
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16
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Serati M, Espuña-Pons M, Mouton-Puglisi A, Padoa A. Iron deficiency and sexual dysfunction in women. Sex Med Rev 2023; 11:342-348. [PMID: 37433756 DOI: 10.1093/sxmrev/qead028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 07/13/2023]
Abstract
INTRODUCTION Sexual dysfunction negatively affects approximately 40% to 50% of adult women across various stages of life. Common risk factors include sexual traumas, relationship problems, chronic conditions, medication side effects, and poor physical health, including iron deficiency. OBJECTIVES This review summarizes a presentation from a symposium that discussed the types and causes of sexual dysfunction at key times in women's lives, focusing on the relationship between iron deficiency and sexual dysfunction. METHODS The symposium was held at the XV Annual European Urogynaecological Association Congress, Antibes, France, in October 2022. Symposium content was identified through literature searches of PubMed. Original research, review articles, and Cochrane analyses discussing sexual dysfunction in association with iron deficiency/anemia were included. RESULTS Iron deficiency in women is commonly caused by abnormal uterine bleeding, but women may develop iron deficiency anemia (IDA) because of increased iron needs or reduced iron intake/absorption. Treatment with oral iron supplementation has been shown to improve sexual function in women with IDA. Ferrous sulphate is considered as a standard of care for oral iron treatment; prolonged-release iron formulations have improved tolerability, enabling lower doses and better tolerability. CONCLUSION IDA and sexual dysfunction are related, so the identification of sexual dysfunction or iron deficiency in a woman should prompt an investigation of the other condition. Testing for iron deficiency is an inexpensive and simple step that can be routinely included in the workup of women with sexual dysfunction. Once identified, IDA and sexual dysfunction in women should be treated and followed to optimize quality of life.
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Affiliation(s)
- Maurizio Serati
- Urogynaecology Unit, Department of Obstetrics and Gynaecology, University of Insubria, 21100 Varese, Italy
| | - Montserrat Espuña-Pons
- Department of Obstetrics and Gynecology, University of Barcelona, 08036 Barcelona, Spain
| | | | - Anna Padoa
- Department of Obstetrics and Gynecology, Shamir Assaf Harofe Medical Center, 7033001 Tsrifin, Israel
- Sackler School of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel
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17
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Jung HJ, Kang MW, Lee JH, Lee JK, Kim JI. The Association of Intravenous Iron Administered the Day before Total Knee Arthroplasty with Postoperative Anemia and Functional Recovery. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1212. [PMID: 37512024 PMCID: PMC10384006 DOI: 10.3390/medicina59071212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: Total knee arthroplasty (TKA) involves blood loss, increasing the risk of postoperative anemia and delayed functional recovery. Intravenous (IV) iron supplementation limits postoperative anemia; however, the effectiveness of IV iron, administered one day before TKA, on postoperative anemia and functional recovery has scarcely been studied. Materials and Methods: We conducted a retrospective cohort study with propensity score matching using two consecutive groups of patients who underwent TKA using tranexamic acid: the iron group received 500 mg ferric derisomaltose intravenously one day before surgery (n = 46); the non-iron group did not (n = 46). Hemoglobin (Hb) level was determined at postoperative days (PODs) 2, 4, 6, 14, and 30. Ferritin, transferrin saturation (TSAT), and functional iron deficiency anemia (IDA) rate were measured at PODs 2, 4, 6, and 14. Length of hospital stay and transfusion rate were also evaluated. Results: The iron group had higher Hb levels at PODs 6, 14, and 30 and higher ferritin and TSAT at PODs 2, 4, 6, and 14. The functional IDA rate was significantly higher in the non-iron group at PODs 2, 4, 6, and 14. Length of hospital stay was significantly shorter in the iron group; however, the rate of transfusion did not differ between the two groups. Conclusions: IV iron administered one day before TKA was associated with postoperative anemia recovery and length of hospital stay; however, it did not lower the postoperative transfusion rate.
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Affiliation(s)
- Ho Jung Jung
- Department of Orthopaedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77, Sakju-ro, Chuncheon-si 24253, Republic of Korea
| | - Min Wook Kang
- Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Republic of Korea
| | - Jong Hwa Lee
- Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Republic of Korea
| | - Joon Kyu Lee
- Department of Orthopaedic Surgery, Konkuk University Medical Center, Konkuk University School of Medcine, Seoul 05030, Republic of Korea
| | - Joong Il Kim
- Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Republic of Korea
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18
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Stefan MW, Gundermann DM, Sharp MH, Jennings BA, Gheith RH, Lowery RP, LowDog T, Ghatak SB, Barbosa J, Wilson JM. Assessment of the Efficacy of a Low-Dose Iron Supplement in Restoring Iron Levels to Normal Range among Healthy Premenopausal Women with Iron Deficiency without Anemia. Nutrients 2023; 15:nu15112620. [PMID: 37299583 DOI: 10.3390/nu15112620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
(1) Background: Iron deficiency without anemia (IDWA) is a prevalent health concern in premenopausal women. Oral supplementation of iron may be a viable solution to improve blood-iron status in women; however, the effects of a high-dose iron-supplement regimen have been associated with gastrointestinal side effects. Therefore, the purpose of the present study was to evaluate the effectiveness of a low-dose liquid fermented iron-bisglycinate supplement (LIS) on improving blood-iron status in premenopausal women with IDWA without increasing constipation or gastrointestinal distress. (2) Methods: 85 premenopausal women with IDWA (ferritin < 70 ng/dL and hemoglobin > 11.0 g/dL) took a LIS (27 mg) or a placebo (PLA) for 8 weeks. Blood draws were taken at Wk0 and Wk8 of the study to measure serum-iron markers. In addition, surveys of gastrointestinal distress were administered at Wk0, Wk4, and Wk8 while the profile of mood states (POMS) was surveyed at Wk0 and Wk8. (3) Results: Compared to the placebo, the LIS was able to increase serum ferritin (p = 0.03), total serum iron (p = 0.03), and mean corpuscular volume (p = 0.02), while exhibiting no significant interaction in subjective gastrointestinal distress (p > 0.05). No significant effects were detected for POMS (p > 0.05). (4) Conclusions: Supplementing with LIS appears to improve blood-iron status without causing significant gastrointestinal distress in premenopausal women with IDWA.
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Affiliation(s)
- Matthew W Stefan
- The Applied Science and Performance Institute, Research Division, Tampa, FL 33607, USA
| | | | - Matthew H Sharp
- The Applied Science and Performance Institute, Research Division, Tampa, FL 33607, USA
| | - Brooke A Jennings
- The Applied Science and Performance Institute, Research Division, Tampa, FL 33607, USA
| | - Raad H Gheith
- The Applied Science and Performance Institute, Research Division, Tampa, FL 33607, USA
| | - Ryan P Lowery
- The Applied Science and Performance Institute, Research Division, Tampa, FL 33607, USA
| | | | | | | | - Jacob M Wilson
- The Applied Science and Performance Institute, Research Division, Tampa, FL 33607, USA
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19
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Musa M, Zeppieri M, Atuanya GN, Enaholo ES, Topah EK, Ojo OM, Salati C. Nutritional Factors: Benefits in Glaucoma and Ophthalmologic Pathologies. Life (Basel) 2023; 13:1120. [PMID: 37240765 PMCID: PMC10222847 DOI: 10.3390/life13051120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/17/2023] [Accepted: 04/26/2023] [Indexed: 05/19/2023] Open
Abstract
Glaucoma is a chronic optic neuropathy that can lead to irreversible functional and morphological damage if left untreated. The gold standard therapeutic approaches in managing patients with glaucoma and limiting progression include local drops, laser, and/or surgery, which are all geared at reducing intraocular pressure (IOP). Nutrients, antioxidants, vitamins, organic compounds, and micronutrients have been gaining increasing interest in the past decade as integrative IOP-independent strategies to delay or halt glaucomatous retinal ganglion cell degeneration. In our minireview, we examine the various nutrients and compounds proposed in the current literature for the management of ophthalmology diseases, especially for glaucoma. With respect to each substance considered, this minireview reports the molecular and biological characteristics, neuroprotective activities, antioxidant properties, beneficial mechanisms, and clinical studies published in the past decade in the field of general medicine. This study highlights the potential benefits of these substances in glaucoma and other ophthalmologic pathologies. Nutritional supplementation can thus be useful as integrative IOP-independent strategies in the management of glaucoma and in other ophthalmologic pathologies. Large multicenter clinical trials based on functional and morphologic data collected over long follow-up periods in patients with IOP-independent treatments can pave the way for alternative and/or coadjutant therapeutic options in the management of glaucoma and other ocular pathologies.
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Affiliation(s)
- Mutali Musa
- Department of Optometry, University of Benin, Benin City 300238, Edo State, Nigeria
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | | | | | - Efioshiomoshi Kings Topah
- Department of Optometry, Faculty of Allied Health Sciences, College of Health Sciences Bayero University, Kano 700006, Kano State, Nigeria
| | - Oluwasola Michael Ojo
- School of Optometry and Vision Sciences, College of Health Sciences, University of Ilorin, Ilorin 240003, Kwara State, Nigeria
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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20
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Krishna TPA, Ceasar SA, Maharajan T. Biofortification of Crops to Fight Anemia: Role of Vacuolar Iron Transporters. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2023; 71:3583-3598. [PMID: 36802625 DOI: 10.1021/acs.jafc.2c07727] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Plant-based foods provide all the crucial nutrients for human health. Among these, iron (Fe) is one of the essential micronutrients for plants and humans. A lack of Fe is a major limiting factor affecting crop quality, production, and human health. There are people who suffer from various health problems due to the low intake of Fe in their plant-based foods. Anemia has become a serious public health issue due to Fe deficiency. Enhancing Fe content in the edible part of food crops is a major thrust area for scientists worldwide. Recent progress in nutrient transporters has provided an opportunity to resolve Fe deficiency or nutritional problems in plants and humans. Understanding the structure, function, and regulation of Fe transporters is essential to address Fe deficiency in plants and to improve Fe content in staple food crops. In this review, we summarized the role of Fe transporter family members in the uptake, cellular and intercellular movement, and long-distance transport of Fe in plants. We draw insights into the role of vacuolar membrane transporters in the crop for Fe biofortification. We also provide structural and functional insights into cereal crops' vacuolar iron transporters (VITs). This review will help highlight the importance of VITs for improving the Fe biofortification of crops and alleviating Fe deficiency in humans.
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Affiliation(s)
| | - Stanislaus Antony Ceasar
- Division of Plant Molecular Biology and Biotechnology, Department of Biosciences, Rajagiri College of Social Sciences, Kochi 683104, Kerala, India
| | - Theivanayagam Maharajan
- Division of Plant Molecular Biology and Biotechnology, Department of Biosciences, Rajagiri College of Social Sciences, Kochi 683104, Kerala, India
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21
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Dubiel S. Simple and precise method for determining relative amount of Fe3+ in Fe-gluconate. J Mol Struct 2023. [DOI: 10.1016/j.molstruc.2023.135479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Gofrit SG, Ohayon-Cohen S, Tsur AM, Rabkin V, Michael Shapira M, Finestone AS. Compliance compromises an interventional study on iron supplementation in female combatants. BMJ Mil Health 2023; 169:27-31. [PMID: 31235618 DOI: 10.1136/jramc-2019-001245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Low iron levels are related to overuse injuries, poor physical performance and cognitive impairments in female recruits. The aim of this study was to evaluate iron supplement compliance in female combatants during basic training, and its effect on haemoglobin (Hgb), ferritin and injuries. METHODS 329 female recruits to light infantry units filled induction questionnaires regarding smoking status, previous overuse injuries and iron deficiency. Blood was drawn for Hgb and ferritin. Subjects with ferritin levels below 20 ng/mL were considered iron depleted and were prescribed a ferrous fumarate supplement. After 4 months of basic training, the subjects completed a follow-up questionnaire regarding overuse injuries, reasons for failure to complete basic training and compliance with iron supplementation. Blood tests were repeated. RESULTS Mean ferritin levels declined during training (from 18.1±18.2 to 15.3±9.6, p=0.01). Compliance with iron supplementation was observed in 26 (26.3%) of the subjects. In compliant subjects, Hgb levels remained constant and ferritin levels increased by 2.9±5.4 (p=0.07). The main reasons for reported non-compliance were forgetfulness, 26 (35.6%), and gastrointestinal side effects, 17 (23.3%). Injuries during training were not found to be associated with iron status. Smokers had a significantly higher rate of reported injuries prior to training (p<0.01). CONCLUSIONS Ferritin levels decline during training. Compliance with iron supplementation is low. Iron supplementation has a significant effect on ferritin levels, even in the non-compliance group. Injuries were not related to iron status in this group. Further research is needed in order to clarify the most appropriate iron supplementation method.
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Affiliation(s)
- Shany Guly Gofrit
- Israel Defense Forces Ground Command, Medical Division, Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - S Ohayon-Cohen
- Department of Internal Medicine J, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - A M Tsur
- Israel Defense Forces Ground Command, Medical Division, Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - V Rabkin
- Israel Defense Forces Ground Command, Medical Division, Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - M Michael Shapira
- Israel Defense Forces Ground Command, Medical Division, Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - A S Finestone
- Department of Orthopaedic Surgery, Assaf Harofeh MC, affiliated to the Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
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23
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Lo JO, Benson AE, Martens K, Hedges MA, McMurry HS, DeLoughery T, Aslan JE, Shatzel JJ. The role of oral iron in the treatment of adults with iron deficiency. Eur J Haematol 2023; 110:123-130. [PMID: 36336470 PMCID: PMC9949769 DOI: 10.1111/ejh.13892] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022]
Abstract
Iron deficiency is the most common nutrient deficiency in the world, affecting over 20% of premenopausal women worldwide. Oral iron supplementation is often the first-line treatment for the acute and chronic management of iron deficiency due to its ease and accessibility. However, there is no consensus on the optimal formulation or dosing strategy, or which patients should be preferentially treated with intravenous iron. Management of iron deficiency is complicated by the hepcidin-ferroportin iron regulatory pathway, which has evolved to prevent iron overload and thereby creates an inherent limit on gastrointestinal iron uptake and efficacy of oral iron. Unabsorbed iron propagates many of the side effects that complicate oral iron use including dyspepsia and constipation, all of which can thus be exacerbated by excessive oral iron doses. Daily low dose and every other day dosing protocols have attempted to bypass this physiologic bottleneck to allow for effective absorption and limit side effects; however, this approach has still resulted in low fractional iron absorption. In the following manuscript, we review the pathophysiology of iron absorption and current evidence for various preparations of oral iron. Lastly, we highlight opportunities for further study to advance the care of individuals affected by iron deficiency.
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Affiliation(s)
- Jamie O Lo
- Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR USA
| | - Ashley E. Benson
- Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR USA
| | - Kylee Martens
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR USA
| | - Madeline A. Hedges
- Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR USA
| | - Hannah Stowe McMurry
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR USA
| | - Thomas DeLoughery
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR USA
| | - Joseph E. Aslan
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR USA
| | - Joseph J. Shatzel
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR USA
- Department of Biomedical Engineering, Oregon Health & Science University, OR USA
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Maas LA, Krishna M, Parian AM. Ironing It All Out: A Comprehensive Review of Iron Deficiency Anemia in Inflammatory Bowel Disease Patients. Dig Dis Sci 2023; 68:357-369. [PMID: 35930123 DOI: 10.1007/s10620-022-07599-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/10/2022] [Indexed: 12/09/2022]
Abstract
Iron deficiency anemia affects approximately 45% of patients with inflammatory bowel disease (IBD), negatively impacts the quality of life in this patient population, and significantly burdens our healthcare system. The pathogenesis of iron deficiency in IBD patients is multifactorial, including intestinal bleeding, malabsorption, and inadequate oral intake. Regular screening and diagnosis in these patients are imperative, and often patients have mixed iron deficiency anemia and anemia of chronic disease, especially in those with active inflammation. Iron may be replenished either orally or intravenously. While oral iron is safe, affordable, and easy to administer, patients often suffer from intolerable gastrointestinal side effects, and particularly in IBD patients, oral iron may increase inflammation and contribute to flares. Therefore, although it is substantially underused, intravenous (IV) iron is considered first-line treatment for patients with active disease, severe anemia, oral iron intolerance, and erythropoietin requirements. Several IV iron formulations are available, and iron sucrose and ferric carboxymaltose are the most frequently used and well studied in patients with IBD. However, iron isomaltoside could potentially become a popular choice among providers given its safety, efficacy, and convenience. Overall, screening, diagnosis, and treatment of iron deficiency anemia are important in patients with IBD. Individual patient characteristics, risks, and benefits, and advantages and disadvantages, should be considered when determining the best route and formulation for iron repletion.
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25
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Maltese V, Gatta E, Facondo P, Anelli V, Cavadini M, Buoso C, Bambini F, Delbarba A, Pirola I, Cappelli C. SIMULTANEOUS INTAKE OF LIQUID L-T4 FORMULATION AND IRON SALT: FACT OR FICTION? ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2023; 19:54-58. [PMID: 37601720 PMCID: PMC10439335 DOI: 10.4183/aeb.2023.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Context Hypothyroidism and iron deficiency are among the most common pathologies in population. Therefore, there are a lot of patients assuming both iron salt supplements and levothyroxine therapy. Objective To evaluate the effect of iron salt intake on L-T4 absorption among different L-T4 formulations. Materials and methods A PubMed/MEDLINE, Web of Science, and Scopus research was performed. Original studies and reviews written in English and published online up to 21 December 2022 were selected and reviewed. The final reference list was defined based on the relevance of each paper to the scope of this review. Results The data show an impaired absorption of L-T4 in tablets formulation when taken concomitantly with iron salt supplements. These phenomena seem to be circumvented by new L-T4 formulations. Conclusion Liquid L-T4 formulations can be ingested with iron salts, with no impairment of absorption. More studies are necessary to confirm these data for soft-gel capsules L-T4.
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Affiliation(s)
- V. Maltese
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - E. Gatta
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - P. Facondo
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - V. Anelli
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - M. Cavadini
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - C. Buoso
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - F. Bambini
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - A. Delbarba
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - I. Pirola
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - C. Cappelli
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
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Singh K, Sethi Chopra D, Singh D, Singh N. Nano-formulations in treatment of iron deficiency anaemia: An overview. Clin Nutr ESPEN 2022; 52:12-19. [PMID: 36513444 DOI: 10.1016/j.clnesp.2022.08.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 08/20/2022] [Accepted: 08/30/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Iron deficiency anaemia (IDA) is a significant challenge to global health. The absorption and bioavailability depend on the delivery vehicle being used. Ferrous sulphate is a drug of choice for IDA but leads to frequent gastrointestinal tract side effects that force the patient to discontinue the treatment. Gastrointestinal side effects result from converting bivalent iron into trivalent iron accompanied by reactive oxygen species (ROS) formation. Due to lower absorption, oral preparations of trivalent iron are recommended in patients with intolerance to ferrous sulphate. Nanosized iron preparation can resolved these concerns. The particle size of iron salts has been observed to have a significant impact on iron absorption. The surface area of iron compounds is increased by reducing their particle size, which improves their solubility in gastric juice and boosts their absorption. Sucrosomial iron, ferric citrate complexes, and ferric maltol are some of the novel iron preparations that ensure high bioavailability and good tolerance in chronic kidney disease, congestive heart failure, and inflammatory bowel disease. However, the parenteral route of administration of iron is unacceptable to most patients. Moreover, it leads to high free iron levels in circulation, resulting in ROS generation. CONCLUSION This article provides an informative summary of iron deficiency anaemia causes and treatment through nanoformulations and literature and in-depth patent analysis.
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Affiliation(s)
- Kuldeep Singh
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, 147002, India
| | - Dimple Sethi Chopra
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, 147002, India.
| | - Dhandeep Singh
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, 147002, India
| | - Nirmal Singh
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, 147002, India
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Iqbal S, Ahmed W, Zafar S, Farooq U, Abid J, Shah HBU, Akram S, Ghazanfar M, Ahmad AMR. Effect of inulin, galacto oligosaccharides and iron fortification on iron deficiency anemia among women of reproductive age; a randomized controlled trial. Front Nutr 2022; 9:1028956. [DOI: 10.3389/fnut.2022.1028956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/03/2022] [Indexed: 11/16/2022] Open
Abstract
Iron supplementation and fortification are the well-known approaches to treat iron deficiency anemia (IDA) in women of reproductive age. The objective of the current randomized controlled trial (RCT) was to evaluate the cumulative effects of prebiotics and iron fortification among women of reproductive age. For this purpose, a total of 75 iron deficient women of childbearing age were recruited and randomly divided into 5 groups (4 treatment groups and 1 control group). Four different types of fortified wheat flour were prepared using two iron fortificants (NaFeEDTA and FeSO4) and two prebiotics [inulin and galacto oligosaccharides (GOS)], while control group was treated with iron fortified flour without any prebiotics. Blood samples were collected from overnight fasted women on monthly basis up to 90 days. Hematological indices such as Hemoglobin (Hb), Hematocrit, Red Blood Cell (RBC) Count and Mean Corpuscular Volume (MCV), as well as iron biomarkers including serum iron, ferritin, transferrin, and Total Iron Binding Capacity (TIBC) were evaluated for analyses. The results showed a considerable positive improvement in all iron biomarkers as well as hematological indices among the treatment groups (P-value < 0.05), as compared to the control group. A maximum Hb (11.86 ± 0.24 mg/dL) and hematocrit value (35.06 ± 1.32%), was reported in group G3 which was treated with fortified wheat flour at a dose of 963 mg/kg GOS + 15 ppm FeSO4. On the other hand, highest mean values for RBC Count (4.73 ± 0.41 mil/mm3), MCV (81.41 ± 3.21 fL), serum iron (75.62 ± 2.79 μg/dL), serum transferrin (16.82 ± 0.30 mg/dL), and TIBC (403.68 ± 7.27 μg/dL) were observed in G4 group receiving the fortified wheat flour at a dose of 963 mg/kg GOS + 30 ppm FeSO4 level. The study concluded that prebiotic fortification along with iron salts helps to enhance iron absorption among iron deficiency anemic women of reproductive age.
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Fisyun IV, Kuznetsova TA, Tkacheva YA, Yakubova EV. Results of Randomized Comparative Efficacy Study of Iron Deficiency Anemia Management in Children with Iron III Hydroxide Polymaltose Complex and Iron Sulfate. PEDIATRIC PHARMACOLOGY 2022. [DOI: 10.15690/pf.v19i4.2441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background. The guidelines on selection between iron preparations, iron sulfate (IS) and iron III hydroxide polymaltose complex (HPC), for iron deficiency anemia (IDA) management in pediatrics are contradictory. Objective. The aim of the study is to compare efficacy and safety of iron (III) HPC and IS for IDA treatment in children. Materials and methods. Randomization of children (aged from 1 month to 18 years) with IDA into 2 therapeutic groups was implemented in 2019-2020. on pediatric districts of children’s city outpatient's clinic: IS dosage of 3 mg/kg/day and iron (III) HPC dosage of 5 mg/kg/day. Hemogram monitoring was performed every 14 days. The efficacy was compared according to the rate of Hb level increase, erythrocytes indices, and serum ferritin (SF) level at the recorded moment of Hb normalization. For the safety — the rate of adverse effects. Results. 65 children with IDA were included in the study and randomized into 2 groups, the median age was 2.3 years (1st; 3rd quartile = 1.1; 4.3). Hb level increase was comparable in both groups (0.34 (0.23; 0.48) g/L/day and 0.24 (0.21; 0.30) g/L/day, р = 0.891). IS is more effective than iron (III) HPC in terms of average red blood cell volume by the time of Hb normalization (83.5 (80.0; 86.7) fl against 80.7 (79.0; 82.0) fl, р = 0.006), and mean cellular hemoglobin content (28.9 (SD = 2.0) pg against 27.4 (SD = 1.8) pg, р = 0.004). The timing of SF levels normalization did not differ. Adverse effects to iron III HPC treatment occurred 5.5 times more frequently than to IS (p = 0.0001). Conclusion. The efficacy of IS and iron III HPC at standard doses is comparable. The advantage in tolerability and recovery of erythrocytic indices justifies the feasibility of using IS preparations in the first line of treatment for children with IDA.
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Affiliation(s)
- Ivan V. Fisyun
- Orel State University named after I.S. Turgenev, Medical Institute
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Pan K, Pang S, Robinson M, Goede D, Meenrajan S. A review of perioperative anemia: A modifiable and not so benign risk factor. J Family Med Prim Care 2022; 11:5004-5009. [PMID: 36505526 PMCID: PMC9731044 DOI: 10.4103/jfmpc.jfmpc_2209_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/01/2022] [Accepted: 04/01/2022] [Indexed: 11/05/2022] Open
Abstract
Anemia is a commonly encountered finding either during the preoperative assessment or during the postoperative management of the patient. Anemia often gets overlooked while more emphasis is paid to cardiovascular and pulmonary evaluation. Evidence, however, suggests that the presence of anemia in the perioperative period can predispose patients to other complications. Awareness of the consequences of anemia in the perioperative period can lead to better recognition and early management of this potentially modifiable risk factor. In this review, we focus on the effects of anemia on the cardiac, pulmonary, neurologic, cognitive, and functional status outcomes of patients. We also review management strategies that could be employed, depending on the available time and resources.
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Affiliation(s)
- Kelsey Pan
- Department of Internal Medicine, University of Florida, Gainesville, USA,Address for correspondence: Dr. Kelsey Pan, Department of Internal Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, USA. E-mail:
| | - Shiyi Pang
- Department of Internal Medicine, University of Florida, Gainesville, USA
| | - Michael Robinson
- Department of Internal Medicine, University of Florida, Gainesville, USA
| | - Dianne Goede
- Department of Internal Medicine, University of Florida, Gainesville, USA
| | - Senthil Meenrajan
- Department of Internal Medicine, University of Florida, Gainesville, USA
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Patil PS, Chakraborty A, Kadam SS, Kharkar PS, Patwardhan AV, Joshi SV. Greener approach for process intensification of iron haematinics by membrane nanofiltration. J INDIAN CHEM SOC 2022; 99:100510. [DOI: 10.1016/j.jics.2022.100510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Georgiou K, Belev NA, Koutouratsas T, Katifelis H, Gazouli M. Gut microbiome: Linking together obesity, bariatric surgery and associated clinical outcomes under a single focus. World J Gastrointest Pathophysiol 2022; 13:59-72. [PMID: 35720165 PMCID: PMC9157685 DOI: 10.4291/wjgp.v13.i3.59] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/21/2021] [Accepted: 03/25/2022] [Indexed: 02/06/2023] Open
Abstract
Obesity is increasingly prevalent in the post-industrial era, with increased mortality rates. The gut microbiota has a central role in immunological, nutritional and metabolism mediated functions, and due to its multiplexity, it is considered an independent organ. Modern high-throughput sequencing techniques have allowed phylogenetic exploration and quantitative analyses of gut microbiome and improved our current understanding of the gut microbiota in health and disease. Its role in obesity and its changes following bariatric surgery have been highlighted in several studies. According to current literature, obesity is linked to a particular microbiota profile that grants the host an augmented potential for calorie release, while limited diversity of gut microbiome has also been observed. Moreover, bariatric surgery procedures represent effective interventions for sustained weight loss and restore a healthier microbiota, contributing to the observed fat mass reduction and lean mass increase. However, newer evidence has shown that gut microbiota is only partially recovered following bariatric surgery. Moreover, several targets including FGF15/19 (a gut-derived peptide), could be responsible for the favorable metabolic changes of bariatric surgery. More randomized controlled trials and larger prospective studies that include well-defined cohorts are required to better identify associations between gut microbiota, obesity, and bariatric surgery.
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Affiliation(s)
- Konstantinos Georgiou
- The First Propaedeutic Surgical Unit, Hippocrateion Athens General Hospital, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Nikolay A Belev
- Medical Simulation Training Center, Research Institute of Medical University of Plovdiv, and UMPHAT “Eurohospital”, Medical University of Plovdiv, Plovdiv 4002, Bulgaria
| | - Tilemachos Koutouratsas
- Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Hector Katifelis
- Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Maria Gazouli
- Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
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Micheletto M, Gaio E, Tedesco E, Di Maira G, Mantovan E, Zanella M, Pastore P, Roverso M, Favaro G, Benetti F. Intestinal Absorption Study of a Granular Form of Ferric Pyrophosphate. Metabolites 2022; 12:463. [PMID: 35629967 PMCID: PMC9145852 DOI: 10.3390/metabo12050463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/30/2022] [Accepted: 05/19/2022] [Indexed: 02/01/2023] Open
Abstract
Iron deficiency is one of the most prevalent nutritional disorders worldwide. The standard treatment involves iron supplementation, but this task is challenging because of poor solubility and organoleptic issues. Moreover, the need to increase iron bioavailability represents a challenge for treating iron-related disorders. In this study, gastroresistance and iron intestinal absorption of an innovative granular formulation composed of ferric pyrophosphate, modified starch and phospholipids branded as Ferro Fosfosoma® was investigated. Gastroresistant properties were studied using standard protocols, and a bioaccessible fraction was obtained by exposing a food supplement to in vitro digestion. This fraction was used for investigating iron absorption in Caco-2 and human follicle-associated intestinal epithelium (FAE) models. Ferro Fosfosoma® showed an improved resistance to gastric digestion and higher intestinal absorption than ferric pyrophosphate salt used as a control in both models. In the FAE model, Ferro Fosfosoma® induces larger iron absorption than in the Caco-2 monolayer, most likely due to the transcytosis ability of M cells. The larger iron absorption in the Ferro Fosfosoma®-treated FAE model corresponds to higher ferritin level, proving physiological iron handling that was once delivered by granular formulation. Finally, the formulation did not induce any alterations in viability and barrier integrity. To conclude, Ferro Fosfosoma® favors iron absorption and ferritin expression, while preserving any adverse effects.
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Affiliation(s)
- Marta Micheletto
- ECSIN-European Center for the Sustainable Impact of Nanotechnology, ECAMRICERT SRL, 35127 Padova, Italy; (M.M.); (E.G.); (E.T.); (G.D.M.); (E.M.); (M.Z.)
| | - Elisa Gaio
- ECSIN-European Center for the Sustainable Impact of Nanotechnology, ECAMRICERT SRL, 35127 Padova, Italy; (M.M.); (E.G.); (E.T.); (G.D.M.); (E.M.); (M.Z.)
| | - Erik Tedesco
- ECSIN-European Center for the Sustainable Impact of Nanotechnology, ECAMRICERT SRL, 35127 Padova, Italy; (M.M.); (E.G.); (E.T.); (G.D.M.); (E.M.); (M.Z.)
| | - Giovanni Di Maira
- ECSIN-European Center for the Sustainable Impact of Nanotechnology, ECAMRICERT SRL, 35127 Padova, Italy; (M.M.); (E.G.); (E.T.); (G.D.M.); (E.M.); (M.Z.)
| | - Etienne Mantovan
- ECSIN-European Center for the Sustainable Impact of Nanotechnology, ECAMRICERT SRL, 35127 Padova, Italy; (M.M.); (E.G.); (E.T.); (G.D.M.); (E.M.); (M.Z.)
| | - Michela Zanella
- ECSIN-European Center for the Sustainable Impact of Nanotechnology, ECAMRICERT SRL, 35127 Padova, Italy; (M.M.); (E.G.); (E.T.); (G.D.M.); (E.M.); (M.Z.)
| | - Paolo Pastore
- Department of Chemical Sciences, University of Padova, 35131 Padova, Italy; (P.P.); (M.R.); (G.F.)
| | - Marco Roverso
- Department of Chemical Sciences, University of Padova, 35131 Padova, Italy; (P.P.); (M.R.); (G.F.)
| | - Gabriella Favaro
- Department of Chemical Sciences, University of Padova, 35131 Padova, Italy; (P.P.); (M.R.); (G.F.)
| | - Federico Benetti
- ECSIN-European Center for the Sustainable Impact of Nanotechnology, ECAMRICERT SRL, 35127 Padova, Italy; (M.M.); (E.G.); (E.T.); (G.D.M.); (E.M.); (M.Z.)
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Chen J, Wang Y, Pan J, Lu LW, Yu J, Liu B, Chen F, Deng H. Prebiotic Oligosaccharides Enhance Iron Absorption Via Modulation of Protein Expression and Gut Microbiota in a Dose‐response Manner in Iron‐deficient Growing Rats. Mol Nutr Food Res 2022; 66:e2101064. [DOI: 10.1002/mnfr.202101064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/03/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Jie‐Hua Chen
- Institute for Innovat ive Development of Food Industry Shenzhen University Shenzhen 518060 China
- Shenzhen Key Laboratory of Marine Microbiome Engineering Institute for Advanced Study Shenzhen University Shenzhen 518060 China
- Department of Nutrition and food Hygiene School of Public Health Southern Medical University Guangzhou 510515 China
| | - Yiyuan Wang
- Department of Nutrition and food Hygiene School of Public Health Southern Medical University Guangzhou 510515 China
- Department of Nutrition and food Hygiene School of Public Health Southern Medical University, Guangzhou, China Zhuhai Maternity and Child Health Hospital Zhuhai 519001 China
| | - Jialiang Pan
- Department of Inspection and Quarantine School of Public Health Southern Medical University Guangzhou 510515 China
| | - Louise Weiwei Lu
- Human Nutrition Unit School of Biological Sciences University of Auckland Auckland 1010 New Zealand
- High Value Nutrition National Science Challenge Auckland 1142 New Zealand
| | - Jianfeng Yu
- Institute for Innovat ive Development of Food Industry Shenzhen University Shenzhen 518060 China
- Shenzhen Key Laboratory of Marine Microbiome Engineering Institute for Advanced Study Shenzhen University Shenzhen 518060 China
| | - Bin Liu
- Institute for Innovat ive Development of Food Industry Shenzhen University Shenzhen 518060 China
- Shenzhen Key Laboratory of Marine Microbiome Engineering Institute for Advanced Study Shenzhen University Shenzhen 518060 China
| | - Feng Chen
- Institute for Innovat ive Development of Food Industry Shenzhen University Shenzhen 518060 China
- Shenzhen Key Laboratory of Marine Microbiome Engineering Institute for Advanced Study Shenzhen University Shenzhen 518060 China
| | - Hong Deng
- Department of Nutrition and food Hygiene School of Public Health Southern Medical University Guangzhou 510515 China
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Four AAs increase DMT1 abundance in duodenal brush-border membrane vesicles and enhance iron absorption in iron-deprived mice. Blood Adv 2022; 6:3011-3021. [PMID: 35061889 PMCID: PMC9131898 DOI: 10.1182/bloodadvances.2021005111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 01/09/2022] [Indexed: 11/20/2022] Open
Abstract
Oral iron supplementation is usually recommended to treat iron-deficiency anemia; however, excess enteral iron has negative side effects. We identified 4 AAs that stimulate intestinal iron absorption and may potentiate iron repletion at lower effective supplemental doses. Iron-deficiency anemia is common worldwide and typically treated by oral iron supplementation. Excess enteral iron, however, may cause pathological outcomes. Developing new repletion approaches is thus warranted. Previous experimentation revealed that select amino acids (AAs) induce trafficking of transporters onto the enterocyte brush-border membrane (BBM) and enhance electrolyte absorption/secretion. Here, we hypothesized that certain AAs would increase the abundance of the main intestinal iron importer, divalent metal-ion transporter 1 (DMT1), on the BBM of duodenal enterocytes, thus stimulating iron absorption. Accordingly, all 20 AAs were screened using an ex vivo duodenal loop/DMT1 western blotting approach. Four AAs (Asp, Gln, Glu, and Gly) were selected for further experimentation and combined into a new formulation. The 4 AAs stimulated 59Fe transport in mouse duodenal epithelial sheets in Ussing chambers (∼4-fold; P < .05). In iron-deprived mice, oral intragastric administration of the 4 AA formulation increased DMT1 protein abundance on the enterocyte BBM by ∼1.5-fold (P < .05). The 4 AAs also enhanced in vivo 59Fe absorption by ∼2-fold (P < .05), even when ∼26 µg of cold iron was included in the transport solution (equal to a human dose of ∼73 mg). Further experimentation using DMT1int/int mice showed that intestinal DMT1 was required for induction of iron transport by the 4 AAs. Select AAs thus enhance iron absorption by inducing DMT1 trafficking onto the apical membrane of duodenal enterocytes. We speculate that further refinement of this new 4 AA formulation will ultimately allow iron repletion at lower effective doses (thus mitigating negative side effects of excess enteral iron).
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The Usefulness of X-ray Diffraction and Thermal Analysis to Study Dietary Supplements Containing Iron. Molecules 2021; 27:molecules27010197. [PMID: 35011434 PMCID: PMC8746380 DOI: 10.3390/molecules27010197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/22/2021] [Accepted: 12/27/2021] [Indexed: 12/27/2022] Open
Abstract
X-ray powder diffraction (XRPD) and thermal analysis (differential scanning calorimetry/derivative of thermogravimetry (DSC/DTG)) are solid-state techniques that can be successfully used to identify and quantify various chemical compounds in polycrystalline mixtures, such as dietary supplements or drugs. In this work, 31 dietary supplements available on the Polish market that contain iron compounds, namely iron gluconate, fumarate, bisglycinate, citrate and pyrophosphate, were evaluated. The aim of the work was to identify iron compounds declared by the manufacturer as food supplements and to try to verify compliance with the manufacturer’s claims. Studies performed by X-ray and thermal analysis confirmed that crystalline iron compounds (iron (II) gluconate, iron (II) fumarate), declared by the manufacturers, were present in the investigated dietary supplements. Iron (II) bisglycinate proved to be semi-crystalline. However, depending on the composition of the formulation, it was possible to identify this compound in the tested supplements. For amorphous iron compounds (iron (III) citrate and iron (III) pyrophosphate), the diffraction pattern does not have characteristic diffraction lines. Food supplements containing crystalline iron compounds have a melting point close to the melting point of pure iron compounds. The presence of excipients was found to affect the shapes and positions of the endothermic peaks significantly. Widening of endothermic peaks and changes in their position were observed, as well as exothermic peaks indicating crystallization of amorphous compounds. Weight loss was determined for all dietary supplements tested. Analysis of the DTG curves showed that the thermal decomposition of most food supplements takes place in several steps. The results obtained by a combination of both simple, relatively fast and reliable XRPD and DSC/DTG methods are helpful in determining phase composition, pharmaceutical abnormalities or by detecting the presence of the correct polymorphic form.
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Mineral Composition of Dietary Supplements-Analytical and Chemometric Approach. Nutrients 2021; 14:nu14010106. [PMID: 35010980 PMCID: PMC8746997 DOI: 10.3390/nu14010106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/21/2021] [Accepted: 12/24/2021] [Indexed: 12/13/2022] Open
Abstract
There is a lack of data on the actual composition and effectiveness of beetroot-based dietary supplements. The research aimed to determine the profile of 22 elements (Na, K, Ca, Mg, P, Fe, As, Se, Zn, Cu, Ag, Co, Ni, Mo, Al, Mn, Sr, Cr, Ba, Li, Pb, Cd) in beetroot and its supplements by the microwave plasma atomic emission spectrometry (MP-AES) method. The analytical procedure was optimised and validated. The composition of both groups was compared, assessing compliance with the recommended daily doses for the chosen elements, and the health risk was estimated. Furthermore, chemometric analysis was applied. Beetroots constituted a significant source of elements, especially K, Na, Mg, Ca, P, in contrast to supplements which contained their negligible amounts except from iron-enriched products which provided notable amounts of Fe (38.3–88% of the Recommended Dietary Allowance for an adult male from 19 to 75 years old). Some products were significantly contaminated with toxic elements (As, Cd). Factor and cluster analyses were helpful in the differentiation of beetroot and its supplements in view of their type (vegetable, supplement, iron-enriched supplement), origin, type of cultivation (conventional, organic), and form (capsule, tablet) based on their mineral composition. The obtained results indicate the need for more stringent control of supplements, as they may pose a significant health risk to consumers.
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Color change of primary teeth following exposure to an experimentally synthesized liposomal nano-encapsulated ferrous sulfate drop versus the commercially available iron drops. PEDIATRIC DENTAL JOURNAL 2021. [DOI: 10.1016/j.pdj.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
Iron deficiency without anaemia is common. Patients may present with unexplained, non-specific symptoms. Iron studies will usually show a low ferritin and low transferrin saturation with a normal haemoglobin concentration. The cause of the iron deficiency should be identified and managed. There is limited evidence about the benefits of giving iron to people who do not have anaemia. If there is iron deficiency, most people can be given oral iron supplements. Iron studies are repeated after 60-90 days of oral iron supplements. Further investigations are needed if the iron deficiency has not been corrected. Some patients, including those who have not responsed to oral supplements may benefit from intravenous iron. There is no role for intramuscular injections of iron.
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Affiliation(s)
- Shalini Balendran
- Westmead Hospital, Sydney
- Central Coast Haematology, Gosford, New South Wales
| | - Cecily Forsyth
- Westmead Hospital, Sydney
- Central Coast Haematology, Gosford, New South Wales
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Bazeley JW, Wish JB. Recent and Emerging Therapies for Iron Deficiency in Anemia of CKD: A Review. Am J Kidney Dis 2021; 79:868-876. [PMID: 34758368 DOI: 10.1053/j.ajkd.2021.09.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/03/2021] [Indexed: 12/29/2022]
Abstract
Iron deficiency commonly contributes to the anemia affecting individuals with chronic kidney disease. Diagnostic criteria for iron deficiency in chronic kidney disease are explained. Mechanisms of functional and absolute iron deficiency and general treatment Principles as delineated in the Kidney Disease: Improving Global Outcomes guidelines are reviewed. Repletion of absolute iron deficits has progressed over time with the addition of better tolerated, more effective oral agents including ferric citrate, ferric maltol, and sucrosomial iron. Structural characteristics and trial data enabling regulatory approval of these novel oral agents are examined. Newer intravenous iron therapies including ferric carboxymaltose and ferric derisomaltose allow for fewer infusions and decreased risk of serious hypersensitivity reactions. Concerns about adverse events including cardiovascular events and infections are discussed. The potential risk of 6H syndrome due to these intravenous agents, including hypophosphatemia, osteomalacia, and pathologic fractures is emphasized. The proposed pathophysiology of 6H syndrome and hypophosphatemia is described. Ferric pyrophosphate citrate enables administration of iron for repletion through dialysate. Relative merits, costs, and risks of various iron agents such as hypersensitivity and 6H syndrome/hypophosphatemia are summarized.
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Affiliation(s)
- Jonathan W Bazeley
- Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jay B Wish
- Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA.
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Beck KL, von Hurst PR, O'Brien WJ, Badenhorst CE. Micronutrients and athletic performance: A review. Food Chem Toxicol 2021; 158:112618. [PMID: 34662692 DOI: 10.1016/j.fct.2021.112618] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 08/04/2021] [Accepted: 10/12/2021] [Indexed: 11/26/2022]
Abstract
Optimising nutrition intake is a key component for supporting athletic performance and supporting adaption to training. Athletes often use micronutrient supplements in order to correct vitamin and mineral deficiencies, improve immune function, enhance recovery and or to optimise their performance. The aim of this review was to investigate the recent literature regarding micronutrients (specifically iron, vitamin C, vitamin E, vitamin D, calcium) and their effects on physical performance. Over the past ten years, several studies have investigated the impacts of these micronutrients on aspects of athletic performance, and several reviews have aimed to provide an overview of current use and effectiveness. Currently the balance of the literature suggests that micronutrient supplementation in well-nourished athletes does not enhance physical performance. Excessive intake of dietary supplements may impair the body's physiological responses to exercise that supports adaptation to training stress. In some cases, micronutrient supplementation is warranted, for example, with a diagnosed deficiency, when energy intake is compromised, or when training and competing at altitude, however these micronutrients should be prescribed by a medical professional. Athletes are encouraged to obtain adequate micronutrients from a wellbalanced and varied dietary intake.
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Affiliation(s)
- Kathryn L Beck
- School of Sport, Exercise and Nutrition, College of Health, Massey University, New Zealand, Private Bag 102904, North Shore, Auckland, 0745, New Zealand.
| | - Pamela R von Hurst
- School of Sport, Exercise and Nutrition, College of Health, Massey University, New Zealand, Private Bag 102904, North Shore, Auckland, 0745, New Zealand.
| | - Wendy J O'Brien
- School of Sport, Exercise and Nutrition, College of Health, Massey University, New Zealand, Private Bag 102904, North Shore, Auckland, 0745, New Zealand.
| | - Claire E Badenhorst
- School of Sport, Exercise and Nutrition, College of Health, Massey University, New Zealand, Private Bag 102904, North Shore, Auckland, 0745, New Zealand.
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Cuisiniere T, Calvé A, Fragoso G, Oliero M, Hajjar R, Gonzalez E, Santos MM. Oral iron supplementation after antibiotic exposure induces a deleterious recovery of the gut microbiota. BMC Microbiol 2021; 21:259. [PMID: 34583649 PMCID: PMC8480066 DOI: 10.1186/s12866-021-02320-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/16/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Oral iron supplementation is commonly prescribed for anemia and may play an important role in the gut microbiota recovery of anemic individuals who received antibiotic treatment. This study aims to investigate the effects of iron supplementation on gut microbiota recovery after antibiotics exposure. RESULTS Mice were subjected to oral antibiotic treatment with neomycin and metronidazole and were fed diets with different concentrations of iron. The composition of the gut microbiota was followed throughout treatment by 16S rRNA sequencing of DNA extracted from fecal samples. Gut microbiota functions were inferred using PICRUSt2, and short-chain fatty acid concentration in fecal samples was assessed by liquid-chromatography mass spectrometry. Iron supplementation after antibiotic exposure shifted the gut microbiota composition towards a Bacteroidetes phylum-dominant composition. At the genus level, the iron-supplemented diet induced an increase in the abundance of Parasutterella and Bacteroides, and a decrease of Bilophila and Akkermansia. Parasutterella excrementihominis, Bacteroides vulgatus, and Alistipes finegoldii, were more abundant with the iron excess diet. Iron-induced shifts in microbiota composition were accompanied by functional modifications, including an enhancement of the biosynthesis of primary bile acids, nitrogen metabolism, cyanoamino acid metabolism and pentose phosphate pathways. Recovery after antibiotic treatment increased propionate levels independent of luminal iron levels, whereas butyrate levels were diminished by excess iron. CONCLUSIONS Oral iron supplementation after antibiotic therapy in mice may lead to deleterious changes in the recovery of the gut microbiota. Our results have implications on the use of oral iron supplementation after antibiotic exposure and justify further studies on alternative treatments for anemia in these settings.
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Affiliation(s)
- Thibault Cuisiniere
- Nutrition and Microbiome Laboratory, Institut du cancer de Montréal, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), CRCHUM - R10.426, 900 rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - Annie Calvé
- Nutrition and Microbiome Laboratory, Institut du cancer de Montréal, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), CRCHUM - R10.426, 900 rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - Gabriela Fragoso
- Nutrition and Microbiome Laboratory, Institut du cancer de Montréal, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), CRCHUM - R10.426, 900 rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - Manon Oliero
- Nutrition and Microbiome Laboratory, Institut du cancer de Montréal, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), CRCHUM - R10.426, 900 rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - Roy Hajjar
- Nutrition and Microbiome Laboratory, Institut du cancer de Montréal, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), CRCHUM - R10.426, 900 rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
- Digestive Surgery Service, Centre hospitalier de l'Université de Montréal, Montréal, Canada
| | - Emmanuel Gonzalez
- Canadian Centre for Computational Genomics, Department of Human Genetics; and Microbiome Platform Research, McGill Interdisciplinary Initiative in Infection and Immunity, McGill University, Montréal, Canada
| | - Manuela M Santos
- Nutrition and Microbiome Laboratory, Institut du cancer de Montréal, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), CRCHUM - R10.426, 900 rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada.
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Canada.
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Berry T, Abohamza E, Moustafa AA. Treatment-resistant schizophrenia: focus on the transsulfuration pathway. Rev Neurosci 2021; 31:219-232. [PMID: 31714892 DOI: 10.1515/revneuro-2019-0057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 07/19/2019] [Indexed: 12/12/2022]
Abstract
Treatment-resistant schizophrenia (TRS) is a severe form of schizophrenia. The severity of illness is positively related to homocysteine levels, with high homocysteine levels due to the low activity of the transsulfuration pathway, which metabolizes homocysteine in synthesizing L-cysteine. Glutathione levels are low in schizophrenia, which indicates shortages of L-cysteine and low activity of the transsulfuration pathway. Hydrogen sulfide (H2S) levels are low in schizophrenia. H2S is synthesized by cystathionine β-synthase and cystathionine γ-lyase, which are the two enzymes in the transsulfuration pathway. Iron-sulfur proteins obtain sulfur from L-cysteine. The oxidative phosphorylation (OXPHOS) pathway has various iron-sulfur proteins. With low levels of L-cysteine, iron-sulfur cluster formation will be dysregulated leading to deficits in OXPHOS in schizophrenia. Molybdenum cofactor (MoCo) synthesis requires sulfur, which is obtained from L-cysteine. With low levels of MoCo synthesis, molybdenum-dependent sulfite oxidase (SUOX) will not be synthesized at appropriate levels. SUOX detoxifies sulfite from sulfur-containing amino acids. If sulfites are not detoxified, there can be sulfite toxicity. The transsulfuration pathway metabolizes selenomethionine, whereby selenium from selenomethionine can be used for selenoprotein synthesis. The low activity of the transsulfuration pathway decreases selenoprotein synthesis. Glutathione peroxidase (GPX), with various GPXs being selenoprotein, is low in schizophrenia. The dysregulations of selenoproteins would lead to oxidant stress, which would increase the methylation of genes and histones leading to epigenetic changes in TRS. An add-on treatment to mainline antipsychotics is proposed for TRS that targets the dysregulations of the transsulfuration pathway and the dysregulations of other pathways stemming from the transsulfuration pathway being dysregulated.
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Affiliation(s)
- Thomas Berry
- School of Social Sciences and Psychology, Western Sydney University, Sydney 2751, New South Wales, Australia
| | - Eid Abohamza
- Department of Social Sciences, College of Arts and Sciences, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Western Sydney University, Sydney 2751, New South Wales, Australia.,Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney 2751, New South Wales, Australia
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Holtzman B, Ackerman KE. Recommendations and Nutritional Considerations for Female Athletes: Health and Performance. Sports Med 2021; 51:43-57. [PMID: 34515972 PMCID: PMC8566643 DOI: 10.1007/s40279-021-01508-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 11/29/2022]
Abstract
Optimal nutrition is an important aspect of an athlete’s preparation to achieve optimal health and performance. While general concepts about micro- and macronutrients and timing of food and fluids are addressed in sports science, rarely are the specific effects of women’s physiology on energy and fluid needs highly considered in research or clinical practice. Women differ from men not only in size, but in body composition and hormonal milieu, and also differ from one another. Their monthly hormonal cycles, with fluctuations in estrogen and progesterone, have varying effects on metabolism and fluid retention. Such cycles can change from month to month, can be suppressed with exogenous hormones, and may even be manipulated to capitalize on ideal timing for performance. But before such physiology can be manipulated, its relationship with nutrition and performance must be understood. This review will address general concepts regarding substrate metabolism in women versus men, common menstrual patterns of female athletes, nutrient and hydration needs during different phases of the menstrual cycle, and health and performance issues related to menstrual cycle disruption. We will discuss up-to-date recommendations for fueling female athletes, describe areas that require further exploration, and address methodological considerations to inform future work in this important area.
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Affiliation(s)
- Bryan Holtzman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Kathryn E Ackerman
- Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, MA, USA. .,Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
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Lorinczova HT, Begum G, Renshaw D, Zariwala MG. Acute Administration of Bioavailable Curcumin Alongside Ferrous Sulphate Supplements Does Not Impair Iron Absorption in Healthy Adults in a Randomised Trial. Nutrients 2021; 13:nu13072300. [PMID: 34371810 PMCID: PMC8308323 DOI: 10.3390/nu13072300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/17/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022] Open
Abstract
Ferrous sulphate (FS) is a cost effective, readily available iron supplement for iron deficiency (ID). The pro-oxidant effect of oral ferrous iron is known to induce inflammation, causing gastric side-effects and resulting in poor compliance. Curcumin is a potent antioxidant and has also been shown to exhibit iron chelation in-vitro, although it is not established whether these effects are retained in-vivo. The aim of this study was therefore to assess the influence of a formulated bioavailable form of curcumin (HydroCurcTM; 500 mg) on acute iron absorption and status in a double blind, placebo-controlled randomized trial recruiting 155 healthy participants (79 males; 26.42 years ± 0.55 and 76 females; 25.82 years ± 0.54). Participants were randomly allocated to five different treatment groups: iron and curcumin placebo (FS0_Plac), low dose (18 mg) iron and curcumin placebo (FS18_Plac), low dose iron and curcumin (FS18_Curc), high dose (65 mg) iron and curcumin placebo (FS65_Plac), and high dose iron and curcumin (FS65_Curc). Participants were provided with the supplements according to their relevant treatment groups at baseline (0 min), and blood collection was carried out at 0 min and at 180 min following supplementation. In the treatment groups, significant difference was observed in mean serum iron between baseline (0 min) and at end-point (180 min) (F (1, 144) = 331.9, p < 0.0001) with statistically significant intra-group increases after 180 min (p < 0.0001) in the FS18_Plac (8.79 µmol/L), FS18_Curc (11.41 µmol/L), FS65_Plac (19.09 µmol/L), and FS65_Curc (16.39 µmol/L) groups. A significant difference was also observed between the two time points in serum TIBC levels and in whole blood haemoglobin (HGB) in the treatment groups, with a significant increase (1.55%/2.04 g/L) in HGB levels from baseline to end-point observed in the FS65_Curc group (p < 0.05). All groups receiving iron demonstrated an increase in transferrin saturation (TS%) in a dose-related manner, demonstrating that increases in serum iron are translated into increases in physiological iron transportation. This study demonstrates, for the first time, that regardless of ferrous dose, formulated curcumin in the form of HydroCurc™ does not negatively influence acute iron absorption in healthy humans.
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Affiliation(s)
- Helena Tiekou Lorinczova
- Centre for Nutraceuticals, School of Life Sciences, University of Westminster, 115 New Cavendish Street, London W1W 6UW, UK; (H.T.L.); (G.B.)
| | - Gulshanara Begum
- Centre for Nutraceuticals, School of Life Sciences, University of Westminster, 115 New Cavendish Street, London W1W 6UW, UK; (H.T.L.); (G.B.)
| | - Derek Renshaw
- Centre for Sport, Exercise and Life Sciences, Institute for Health and Wellbeing, Coventry University, Priory St, Coventry CV1 5FB, UK;
| | - Mohammed Gulrez Zariwala
- Centre for Nutraceuticals, School of Life Sciences, University of Westminster, 115 New Cavendish Street, London W1W 6UW, UK; (H.T.L.); (G.B.)
- Correspondence: ; Tel.: +44-20-7911-5000 (ext. 65086)
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Oral Iron Supplementation—Gastrointestinal Side Effects and the Impact on the Gut Microbiota. MICROBIOLOGY RESEARCH 2021. [DOI: 10.3390/microbiolres12020033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Iron deficiency anaemia (IDA) is a worldwide healthcare problem affecting approximately 25% of the global population. The most common IDA treatment is oral iron supplementation, which has been associated with gastrointestinal (GI) side effects such as constipation and bloating. These can result in treatment non-adherence and the persistence of IDA. Intravenous iron does not cause GI side effects, which may be due to the lack of exposure to the intestinal lumen. Luminal iron can cause changes to the gut microbiota, aiding the promotion of pathogenic species and decreasing beneficial protective species. Iron is vital for methanogenic archaea, which rely on iron for growth and metabolism. Increased intestinal methane has been associated with slowing of intestinal transit, constipation, and bloating. Here we explore the literature to understand a potential link between iron and methanogenesis as a novel way to understand the mechanism of oral iron supplementation induced GI side effects.
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46
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Epigenetic Modulation in Parkinson's Disease and Potential Treatment Therapies. Neurochem Res 2021; 46:1618-1626. [PMID: 33900517 DOI: 10.1007/s11064-021-03334-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/17/2021] [Accepted: 04/20/2021] [Indexed: 12/11/2022]
Abstract
In the recent past, huge emphasis has been given to the epigenetic alterations of the genes responsible for the cause of neurological disorders. Earlier, the scientists believed somatic changes and modifications in the genetic makeup of DNA to be the main cause of the neurodegenerative diseases. With the increase in understanding of the neural network and associated diseases, it was observed that alterations in the gene expression were not always originated by the change in the genetic sequence. For this reason, extensive research has been conducted to understand the role of epigenetics in the pathophysiology of several neurological disorders including Alzheimer's disease, Parkinson's disease and, Huntington's disease. In a healthy person, the epigenetic modifications play a crucial role in maintaining the homeostasis of a cell by either up-regulating or down-regulating the genes. Therefore, improved understanding of these modifications may provide better insight about the diseases and may serve as potential therapeutic targets for their treatment. The present review describes various epigenetic modifications involved in the pathology of Parkinson's Disease (PD) backed by multiple researches carried out to study the gene expression regulation related to the epigenetic alterations. Additionally, we will briefly go through the current scenario about the various treatment therapies including small molecules and multiple phytochemicals potent enough to reverse these alterations and the future directions for a better management of PD.
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Urso K, Leal Martínez-Bujanda J, del Prado JM. Iron Protein Succinylate in the Management of Iron Deficiency Anemia: A Comparative Study with Ferrous Sulphate at Low and High Therapeutic Doses. Nutrients 2021; 13:968. [PMID: 33802720 PMCID: PMC8002401 DOI: 10.3390/nu13030968] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 12/19/2022] Open
Abstract
Oral iron supplementation constitutes the first line treatment for iron deficiency anemia (IDA), with daily doses between 80 mg and 200 mg of elemental iron. Ferrous salts, such as ferrous sulphate (FeSO4), while efficacious, frequently give rise to gastrointestinal side effects. In the present paper we attempted to directly compare the efficacy of an alternative to the FeSO4 formulation, which presents a better tolerability profile, iron protein succinylate (Ferplex®). In a diet-induced anemia model, rats were treated by oral gavage with vehicle, FeSO4, or Ferplex® at a human-dose equivalent of 80 mg and 200 mg of elemental iron. We evaluated the change in anemia-related hematological and biochemical parameters, conducting a histological examination of the intestine at sacrifice. Results indicate that both types of iron supplementation are equally effective in the treatment of IDA, restoring hemoglobin, hematocrit, erythrocytes, free iron and transferrin levels in 15 days, with no statistical differences between treated groups and control. The impact of anemia on body weight was also attenuated following treatment with both iron supplements. Thrombocyte and reticulocyte levels, altered by the anemic condition, returned to homeostasis after 15 days of either FeSO4 or Ferplex® treatment. Importantly, the lower and higher doses of iron were equally effective, thus supporting the current school of thought which states that lower therapeutic doses are sufficient for management of IDA. In addition, the study shows for the first time that oral treatment with Ferplex® does not increase serum hepcidin. Finally, Ferplex® induced minimal iron depositions in the intestinal tissue compared to FeSO4.
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Affiliation(s)
- Katia Urso
- ITF Research Pharma S.L.U., San Rafael 3, 28108 Madrid, Spain;
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The Efficacy and Safety of Using a Combined Iron Supplement in Children with Community-acquired Pneumonia and Anemia. Fam Med 2021. [DOI: 10.30841/2307-5112.5-6.2020.225188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The article summarizes the own data and presents a scientific review of the medical literature devoted to the analysis of the problem of treatment of community-acquired pneumonia associated with anemia in children.
The objective: to optimize the treatment of community-acquired pneumonia associated with anemia in children.
Materials and methods. There were examined 100 children (53 girls and 47 boys) aged 9–17 years (the average age was 12.96 ± 0.07 years), who were treated for community-acquired pneumonia in the children’s clinical hospital No. 5 in Kiev. Children were divided into two groups: Group I – 70 patients with community-acquired pneumonia and normal levels of hemoglobin and erythrocytes; Group II – 30 children with pneumonia and anemia of the I – II stages.
Results. During the study of the localization of the pathological process in the lungs, it was found that in children of group II compared with group I, bilateral lung damage was more common (33.3 % compared to 12.9 %; p <0.05). The main indicators of peripheral blood in patients with community-acquired pneumonia and anemia were lower than in patients with community-acquired pneumonia. The clinical picture of community-acquired pneumonia with anemia and also there was analyzed the possibility of using a combined preparation of ferrous iron, manganese and copper for treatment.
Conclusion. It was found that in patients with community-acquired pneumonia and anemia, compared with patients with community-acquired pneumonia, there is a more widespread and severe inflammatory process in the lungs with prominent signs of intoxication. However, when using a medication of ferrous iron with trace elements, an improvement in indicators and the course of the disease is observed.
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Man Y, Xu T, Adhikari B, Zhou C, Wang Y, Wang B. Iron supplementation and iron-fortified foods: a review. Crit Rev Food Sci Nutr 2021; 62:4504-4525. [PMID: 33506686 DOI: 10.1080/10408398.2021.1876623] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
About one-third of the world population is suffering from iron deficiency. Delivery of iron through diet is a practical, economical, and sustainable approach. Clinical studies have shown that the consumption of iron-fortified foods is one of the most effective methods for the prevention of iron deficiency. However, supplementing iron through diet can cause undesirable side-effects. Thus, it is essential to develop new iron-rich ingredients, iron-fortified products with high bioavailability, better stability, and lower cost. It is also essential to develop newer processing technologies for more effective fortification. This review compared the iron supplementation strategies used to treat the highly iron-deficient population and the general public. We also reviewed the efficacy of functional (iron-rich) ingredients that can be incorporated into food materials to produce iron-fortified foods. The most commonly available foods, such as cereals, bakery products, dairy products, beverages, and condiments are still the best vehicles for iron fortification and delivery.Scope of reviewThe manuscript aims at providing a comprehensive review of the latest publications that cover three aspects: administration routes for iron supplementation, iron-rich ingredients used for iron supplementation, and iron-fortified foods.
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Affiliation(s)
- Yaxing Man
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang, PR China
| | - Tiantian Xu
- Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, South China Agricultural University, Guangzhou, PR China
| | - Benu Adhikari
- School of Science, RMIT University, Melbourne, Australia
| | - Cunshan Zhou
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang, PR China
| | - Yuchuan Wang
- School of Food Engineering, Jiangnan University, Wuxi, PR China
| | - Bo Wang
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang, PR China
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Lee KH, Ho Y, Tarng DC. Iron Therapy in Chronic Kidney Disease: Days of Future Past. Int J Mol Sci 2021; 22:1008. [PMID: 33498292 PMCID: PMC7863960 DOI: 10.3390/ijms22031008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/10/2021] [Accepted: 01/18/2021] [Indexed: 02/06/2023] Open
Abstract
Anemia affects millions of patients with chronic kidney disease (CKD) and prompt iron supplementation can lead to reductions in the required dose of erythropoiesis-stimulating agents, thereby reducing medical costs. Oral and intravenous (IV) traditional iron preparations are considered far from ideal, primarily due to gastrointestinal intolerability and the potential risk of infusion reactions, respectively. Fortunately, the emergence of novel iron replacement therapies has engendered a paradigm shift in the treatment of iron deficiency anemia in patients with CKD. For example, oral ferric citrate is an efficacious and safe phosphate binder that increases iron stores to maintain hemoglobin levels. Additional benefits include reductions in fibroblast growth factor 23 levels and the activation of 1,25 dihydroxyvitamin D. The new-generation IV iron preparations ferumoxytol, iron isomaltoside 1000, and ferric carboxymaltose are characterized by a reduced risk of infusion reactions and are clinically well tolerated as a rapid high-dose infusion. In patients undergoing hemodialysis (HD), ferric pyrophosphate citrate (FPC) administered through dialysate enables the replacement of ongoing uremic and HD-related iron loss. FPC transports iron directly to transferrin, bypassing the reticuloendothelial system and avoiding iron sequestration. Moreover, this paper summarizes recent advancements of hypoxia-inducible factor prolyl hydroxylase inhibitors and future perspectives in renal anemia management.
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Affiliation(s)
- Kuo-Hua Lee
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (K.-H.L.); (Y.H.)
- Institute of Clinical Medicine, National Yang-Ming University, Taipei 11217, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-devices (IDSB), Hsinchu 300, Taiwan
| | - Yang Ho
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (K.-H.L.); (Y.H.)
| | - Der-Cherng Tarng
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (K.-H.L.); (Y.H.)
- Institute of Clinical Medicine, National Yang-Ming University, Taipei 11217, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-devices (IDSB), Hsinchu 300, Taiwan
- Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, Hsinchu 300, Taiwan
- Department and Institute of Physiology, National Yang-Ming University, Taipei 11217, Taiwan
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