The Effect of Iron Treatment on Adhesion Molecules in Patients with Iron Deficiency Anemia

The present study was aimed to determine the effect of iron supplementation on levels of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in patients with iron deficiency anemia (IDA). In this study, 26 female patients diagnosed with iron deficiency were treated approximately 3 months of oral iron supplementation (99 ± 10 days; ferrous glycine sulfate; 100 mg/day of elemental iron). Levels of sICAM-1 and sVCAM-1 were assessed prior to treatment and after approximately 3 months of treatment and compared with 26 healthy female subjects. A significant increase in sVCAM levels was found in the patients with iron deficiency at the end of the treatment relative to pretreatment levels compared to controls, whereas no significant differences were determined in sICAM levels. In the posttreatment period, no significant change was observed in sICAM levels compared to the pretreatment levels, whereas sVCAM levels decreased. However, after the treatment period, the sVCAM, hemoglobin, mean corpuscular volume (MCV), and serum ferritin levels did not return to the normal range compared to the controls. Pretreatment sVCAM-1 levels were inversely correlated with levels of hemoglobin, hemotocrit, MCV, serum iron, and ferritin. After treatment, the sVCAM-1 levels were negatively correlated with ferritin levels. Levels of sVCAM were significantly higher in patients with IDA than controls. After the treatment period, the sVCAM levels were not completely normalized in patients with IDA compared to controls, regardless of the presence of inadequate levels of hemoglobin, MCV, and serum ferritin. Thus, iron supplementation not only ameliorates anemia, but may also reduce the inflammation markers in cases with IDA.     

血清Hepcidin 水平在老年缺铁性贫血和慢性病贫血诊断中的临床应用

目的:探讨血清铁调素(Hepcidin)在老年人群缺铁性贫血(IDA)和慢性病贫血(ACD)中的应用价值。方法:选择老年IDA患者32例,老年ACD患者34例,健康对照组28例。检测对比三组血清Hepcidin、血清铁(SI)、血清铁蛋白(SF)、C-反应蛋白(CRP)、红细胞数(RBC)、血红蛋白(Hb)、红细胞比容(HCT)、红细胞平均体积(MCV)、白细胞数(WBC)水平。结果:ACD组中WBC明显高于IDA组(P0.05)。血清Hepcidin在IDA组、ACD组及对照组之间具有显著性差异(P0.05),IDA组中Hepcidin含量比对照组低,而ACD组中Hepcidin含量比对照组高(P0.05)。IDA组、ACD组中SI明显低于对照组(P0.05),而两组间无显著性差异(P0.05)。ACD组中SF、CRP均明显高于IDA组与对照组(P0.05)。Hepcidin诊断IDA组的ROC曲线下面积(AUC)值大于诊断ACD组,IDA组的诊断指数高于ACD组。结论:血清Hepcidin含量的检测对于鉴别IDA和ACD具有重要的意义。     

Determinants of Iron Deficiency Anemia in a Cohort of Children Aged 6-71 Months Living in the Northeast of Minas Gerais,Brazil

Iron deficiency anemia is one of the most common nutritional disorders worldwide. The aim was to identify the prevalence and incidence of anemia in children and to identify predictors of this condition, including intestinal parasites, social, nutritional and environmental factors, and comorbidities. A population-based cohort study was conducted in a sample of 414 children aged 6–71 months living in Novo Cruzeiro in the Minas Gerais State. Data were collected in 2008 and 2009 by interview and included socio-economic and demographic information about the children and their families. Blood samples were collected for testing of hemoglobin, ferritin and C-reactive protein. Anthropometric measurements and parasitological analyses of fecal samples were performed. To identify risk factors associated with anemia multivariate analyses were performed using the generalized estimating equations (GEE). In 2008 and 2009, respectively, the prevalence rates of anemia were 35.9% (95%CI 31.2–40.8) and 9.8% (95%CI 7.2–12.9), the prevalence rates of iron deficiency were 18.4% (95%CI 14.7–22.6) and 21.8% (95%CI 17.8–26.2), and the incidence rates of anemia and iron deficiency were 3.2% and 21.8%. The following risk factors associated with anemia were: iron deficiency (OR = 3.2; 95%CI 2.0-.5.3), parasitic infections (OR = 1.9; 95%CI 1.2–2.8), being of risk of or being a low length/height-for-age (OR = 2.1; 95%CI 1.4–3.2), and lower retinol intake (OR = 1.7; 95%CI 1.1–2.7), adjusted over time. Nutritional factors, parasitic infections and chronic malnutrition were identified as risk factors for anemia. These factors can be verified in a chronic process and have been classically described as risk factors for these conditions.     

鹿茸多肽对缺铁性贫血大鼠的治疗作用及机制研究

摘要 目的：研究鹿茸多肽（PAP）对缺铁性贫血（IDA）大鼠的治疗作用并探讨其可能机制。方法：使用缺铁饲料诱导IDA大鼠模型,将40只IDA大鼠随机分为模型组（灌胃等体积的生理盐水）,Low-PAP组、Medium-PAP组和High-PAP组（分别灌胃30、60和120 mg/kg的PAP）,每组10只,另选取10只正常饲料喂养的同龄健康大鼠作为对照组（灌胃等体积的生理盐水）。每天灌胃1次,疗程为4周。末次给药24 h后,测量各组大鼠的体重、肝脏和脾脏指数,对肝脏和脾脏组织进行苏木素伊红（HE）染色。通过ELISA法检测血红蛋白（Hb）和促红细胞生成素（EPO）含量,通过比色法检测血清铁（SI）含量,通过透射电子显微镜观察肝脏和脾脏线粒体超微结构。使用相应试剂盒检测血清氧化应激指标水平。通过Western blot检测骨髓转铁蛋白受体（TFR）蛋白表达水平。结果：与模型组相比,Low-PAP组、Medium-PAP组和High-PAP组大鼠体重均升高,肝脏和脾脏指数均降低（P<0.05）,且大鼠的肝脏和脾脏形态和线粒体超微结构明显改善,Hb、EPO和SI水平均升高（P<0.05）。与模型组相比,Low-PAP组、Medium-PAP组和High-PAP组大鼠的血清超氧化物歧化酶（SOD）、过氧化氢酶（CAT）和谷胱甘肽过氧化物酶（GSH-PX）水平均升高,而丙二醛（MDA）降低（P<0.05）。与模型组相比,Low-PAP组、Medium-PAP组和High-PAP组大鼠的骨髓TFR蛋白相对表达量降低（P<0.05）。结论：本研究表明PAP可有效减轻IDA大鼠的临床症状,促进红细胞生成,增强造血功能,改善铁代谢,提高抗氧化能力,促进线粒体合成。     

Risk of Cancer in Patients with Iron Deficiency Anemia: A Nationwide Population-Based Study

ObjectiveThis study evaluated the risk of cancer among patients with iron deficiency anemia (IDA) by using a nationwide population-based data set.MethodPatients newly diagnosed with IDA and without antecedent cancer between 2000 and 2010 were recruited from the Taiwan National Health Insurance Research Database. The standardized incidence ratios (SIRs) of cancer types among patients with IDA were calculated.ResultsPatients with IDA exhibited an increased overall cancer risk (SIR: 2.15). Subgroup analysis showed that patients of both sexes and in all age groups had an increased SIR. After we excluded patients diagnosed with cancer within the first and first 5 years of IDA diagnosis, the SIRs remained significantly elevated at 1.43 and 1.30, respectively. In addition, the risks of pancreatic (SIR: 2.31), kidney (SIR: 2.23), liver (SIR: 1.94), and bladder cancers (SIR: 1.74) remained significantly increased after exclusion of patients diagnosed with cancer within 5 years after IDA diagnosis.ConclusionThe overall cancer risk was significantly elevated among patients with IDA. After we excluded patients diagnosed with IDA and cancer within 1 and 5 years, the SIRs remained significantly elevated compared with those of the general population. The increased risk of cancer was not confined to gastrointestinal cancer when the SIRs of pancreatic, kidney, liver, and bladder cancers significantly increased after exclusion of patients diagnosed with IDA and cancer within the first 5 years. This finding may be caused by immune activities altered by IDA. Further study is necessary to determine the association between IDA and cancer risk.     

Phagocytosis, Oxidative Burst, and Produced Reactive Species are Affected by Iron Deficiency Anemia and Anemia of Chronic Diseases in Elderly

Iron and oxidative stress have a regulatory interplay. During the oxidative burst, phagocytic cells produce free radicals such as hypochlorous acid (HOCl). Nevertheless, scarce studies evaluated the effect of either iron deficiency anemia (IDA) or anemia of chronic disease (ACD) on phagocyte function in the elderly. The aim of the present study was to determine the oxidative burst, phagocytosis, and nitric oxide (^?NO) and HOCl, reactive species produced by monocytes and neutrophils in elderly with ACD or IDA. Soluble transferrin receptor, serum ferritin, and soluble transferrin receptor/log ferritin (TfR-F) index determined the iron status. The study was constituted of 39 patients aged over 60 (28 women and 11 men) recruited from the Brazilian Public Health System. Oxidative burst fluorescence intensity per neutrophil in IDA group and HOCl generation in both ACD and IDA groups were found to be lower (p?<?0.05). The percentages of neutrophils and monocytes expressing phagocytosis in ACD group were found to be higher (p?<?0.05). There was an overproduction of ^?NO from monocytes, whereas the fundamental generation of HOCl appeared to be lower. Phagocytosis, oxidative burst, and ^?NO and HOCl production are involved in iron metabolism regulation in elderly patients with ACD and IDA.     

Metabolomic Analysis of Cerebrospinal Fluid Indicates Iron Deficiency Compromises Cerebral Energy Metabolism in the Infant Monkey

Iron deficiency anemia affects many pregnant women and young infants worldwide. The health impact is significant, given iron’s known role in many body functions, including oxidative and lipid metabolism, protein synthesis and brain neurochemistry. The following research determined if ¹H NMR spectroscopy-based metabolomic analysis of cerebrospinal fluid (CSF) could detect the adverse influence of early life iron deficiency on the central nervous system. Using a controlled dietary model in 43 infant primates, distinct differences were found in spectra acquired at 600 MHz from the CSF of anemic monkeys. Three metabolite ratios, citrate/pyruvate, citrate/lactate and pyruvate/glutamine ratios, differed significantly in the iron deficient infant and then normalized following the consumption of dietary iron and improvement of clinical indices of anemia in the heme compartment. This distinctive metabolomic profile associated with anemia in the young infant indicates that CSF can be employed to track the neurological effects of iron deficiency and benefits of iron supplementation.     

生血宝合剂联合琥珀酸亚铁片治疗妊娠期缺铁性贫血的疗效及对铁代谢指标和妊娠结局的影响

摘要 目的：探讨妊娠期缺铁性贫血（IDA）患者经生血宝合剂联合琥珀酸亚铁片治疗后,患者疗效、妊娠结局情况以及铁代谢指标变化情况。方法：选择2016年6月~2021年4月期间在我院接受治疗的妊娠期IDA患者100例。根据信封抽签法将患者分为对照组和研究组,各为50例。对照组患者接受琥珀酸亚铁片治疗,研究组患者接受生血宝合剂联合琥珀酸亚铁片治疗,两组患者均治疗1个月。对比两组疗效、红细胞参数、铁代谢指标、妊娠结局和不良反应发生情况。结果：研究组的临床总有效率较对照组明显更高（P>0.05）。治疗1个月后,两组血红细胞计数（RBC）、红细胞平均体积（MCV）、血红蛋白（Hb）、红细胞平均血红蛋白（MCH）均较治疗前升高,且研究组高于对照组（P<0.05）。治疗1个月后,两组血清铁（SI）、转铁蛋白饱和度（TSAT）、铁蛋白（SF）均较治疗前升高,且研究组高于对照组;转铁蛋白受体（STFR）较治疗前降低,且研究组低于对照组（P<0.05）。两组不良反应发生率对比无差异（P>0.05）。研究组剖宫产率、低体质量儿出生率低于对照组（P<0.05）。结论：生血宝合剂联合琥珀酸亚铁片治疗妊娠期IDA患者疗效显著,可促进其铁代谢恢复,提高红细胞发育程度,降低剖宫产率及低体质量儿出生率,安全可靠。     

妊娠期缺铁性贫血的影响因素及琥珀酸亚铁片的治疗效果研究

摘要 目的：研究妊娠期缺铁性贫血（IDA）的影响因素及琥珀酸亚铁片的治疗效果。方法：选取2017年5月~2019年6月期间我院收治的妊娠期IDA患者156例作为贫血组,选取同期于我院体检的健康妊娠期志愿者100例作为非贫血组。采用抽签法将贫血组患者分为对照组（常规治疗）和研究组（常规治疗基础上给予琥珀酸亚铁片治疗）,各78例,均治疗8周。对比贫血组各亚组患者的疗效、血象指标、铁代谢指标及不良反应发生情况。采用Logistic回归分析妊娠期IDA的影响因素。结果：治疗8周后,研究组的临床总有效率高于对照组（P<0.05）。治疗8周后,研究组的平均血红蛋白量（MCH）、血红蛋白（Hb）、平均红细胞体积（MCV）高于对照组,红细胞体积分布宽度（RDW）低于对照组（P<0.05）。治疗8周后,研究组的血清铁蛋白（SF）、血清铁（SI）高于对照组,血清转铁蛋白受体（sTFR）、总铁结合力（TIBC）低于对照组（P<0.05）。两组的不良反应发生率对比无统计学差异（P>0.05）。单因素分析发现,妊娠期IDA发病与年龄、文化程度、家庭月收入、是否存在不良饮食习惯、是否有慢性胃肠道疾病史、月经初潮年龄、初次性交年龄、初次妊娠年龄、人工流产次数、产次有关（P<0.05）,而与体质量指数无关（P>0.05）。Logistic 回归分析结果显示,年龄>30岁、文化程度为初中及以下、存在不良饮食习惯、伴有慢性胃肠道疾病史、月经初潮年龄<13岁、初次妊娠年龄<18岁、人工流产次数>3次是妊娠期 IDA发病的独立危险因素（P<0.05）。结论：引起妊娠期IDA发病的影响因素较多,应针对这些因素进行干预,以降低妊娠期 IDA 的发生率。琥珀酸亚铁片治疗妊娠期IDA,可有效调节铁代谢,改善红细胞形态,缓解贫血症状,且不增加不良反应发生率。     

生血宁片联合琥珀酸亚铁片治疗妊娠期缺铁性贫血患者的疗效及对铁代谢的影响

目的:探讨生血宁片联合琥珀酸亚铁片治疗妊娠期缺铁性贫血患者的疗效及对铁代谢的影响。方法:选取2015年2月-2017年2月我院收治的妊娠期缺铁性贫血患者200例为研究对象。将其以随机数字表法分成对照组(n=100)和研究组(n=100)。对照组予以口服琥珀酸亚铁片治疗,研究组则予以生血宁片联合琥珀酸亚铁片治疗,两组均连续治疗4周。分别比较两组临床疗效、治疗前后血液学指标、治疗前后铁代谢指标以及不良妊娠结局情况。结果:研究组治疗总有效率明显较对照组升高(P0.05)。治疗后两组患者血红蛋白(Hb)、红细胞(RBC)、平均红细胞体积(MCV)以及平均红细胞血红蛋白浓度(MCHC)水平均明显高于治疗前,且研究组高于对照组(P0.05)。治疗后两组患者血清铁、转铁蛋白饱和度(TSAT)水平均明显高于治疗前,且研究组又明显高于对照组(P0.05)。与对照组比较,研究组不良妊娠结局发生率降低(P0.05)。结论:生血宁片联合琥珀酸亚铁片治疗妊娠期缺铁性贫血患者的临床疗效显著,改善患者血液学指标以及铁代谢水平,降低不良妊娠结局发生风险,值得临床推广应用。     

Effect of Helicobacter pylori Infection on Iron Absorption in Asymptomatic Adults Consuming Wheat Flour Fortified with Iron and Zinc

Helicobacter pylori infection could impair iron absorption from fortified products. The objective of the study was to determine the effect of H. pylori infection on iron absorption from asymptomatic adults consuming wheat flour fortified with iron and zinc. The (13)C urea breath test was used to assess H. pylori infection. Twenty-four H. pylori-positive and 26 H. pylori-negative volunteers completed the study. On day?1, the subjects were randomized to receive for breakfast bread fortified with either ferrous sulfate and zinc sulfate or ferrous fumarate and zinc oxide. Bread fortified with ferrous sulfate was labeled with (59)Fe as sulfate, and bread fortified with ferrous fumarate was labeled with (55)Fe as fumarate. On day?3, they received the other type of bread, with the respective tracers. On days?18-23, a proton pump inhibitor was administered to all subjects. On day?24, all subjects received bread fortified with ferrous fumarate and zinc oxide labeled with (55)Fe as fumarate. H. pylori prevalence was 77.6%. The geometric mean (±1?SD) of iron absorption was significantly higher for ferrous sulfate than fumarate (6.9?±?2.9% vs. 0.5?±?3.5%, p?相似文献   

Effect of Latent Iron Deficiency on 5-Hydroxytryptamine Metabolism in Rat Brain

Eight weeks of latent iron deficiency in weaned rats maintained on an experimental low iron content diet (18-20 mg/kg) did not significantly alter the packed cell volume and hemoglobin concentration; however, the hepatic and brain nonheme iron contents decreased by 66% and 21% (p less than 0.001), respectively. The tryptophan concentration decreased by 31% and 34% in liver and brain, respectively, in rats on experimental diet (p less than 0.01). The brain 5-hydroxytryptamine and 5-hydroxyindoleacetic acid contents were reduced by 21% and 23% (p less than 0.01 and p less than 0.02), respectively. However, in the brain, weight, protein, DNA, and the activities of monoamine oxidase, aldehyde dehydrogenase, and liver tryptophan oxygenase were found to remain unaltered. When rehabilitated with a diet containing 390 mg/kg iron, rats previously maintained on the experimental diet for 2 weeks showed partial recovery in tryptophan levels both in liver and brain. However, brain 5-hydroxytryptamine and 5-hydroxyindoleacetic acid levels remained unaltered. The hepatic iron content improved without any change in brain iron content. The latent iron deficiency produced significant alterations in the metabolism of 5-hydroxytryptamine and brain iron content that could not be recovered 2 weeks after the iron rehabilitation.     

Interactions Between High pH and Iron Supply on Nodulation and Iron Nutrition of Lupinus albus L. Genotypes Differing in Sensitivity to Iron Deficiency

Poor growth of white lupin (Lupinus albus L.) on alkaline soils may result from its sensitivity to iron deficiency and poor nodulation. This study examined interactive effects of iron supply and high pH on the growth and nodulation of three genotypes differing in their sensitivity to iron deficiency. Three genotypes (P27486, Ultra and WTD180) were grown for 17 days in buffered solutions with Fe supply of 0.2, 2 and 20 μM. Solution pH was adjusted to 5.2, 6.5 or 7.5. Plant growth, nodulation and nutrient concentrations in plants were measured. Decreasing Fe supply decreased chlorophyll concentration in young leaves by up to 92%. Increasing pH decreased chlorophyll concentration by an average of 40% at pH 6.5 and by 47% at pH 7.5. The decrease of chlorophyll was less obvious in P27485 than in Ultra or WTD180. Shoot biomass was reduced by up to 18% by Fe deficiency, with such decrease being less for P27486. Increasing pH exacerbated the effect of Fe deficiency on shoot biomass only of Ultra. Decreasing Fe supply decreased nodule number by an average of 54%, and increasing pH decreased nodule number by 80%. P27486 formed the greatest number of nodules while WTD180 the least. P27486 had high Fe uptake and low internal requirement. Irrespective of genotype, leaf chlorosis positively correlated with cluster root formation. The results suggest that a combination of Fe deficiency and high pH impaired nodulation in L. albus, and that selection of genotypes for both tolerance of iron deficiency and good nodulation at high pH is important for a successful lupin crop on alkaline soils.     

Effects of Rahnella aquatilis JZ-GX1 on Treat Chlorosis Induced by Iron Deficiency in Cinnamomum camphora

Journal of Plant Growth Regulation - With the increasing popularity of urban landscaping, there is a greater need to address iron deficiency and chlorosis in Cinnamomum camphora. Beneficial...     

Thimerosal increases the responsiveness of the calcium receptor in human parathyroid and rMTC6-23 cells

Parathyroid cells express a plasma membrane calcium receptor (CaR), which is stimulated by a rise in extracellular calcium concentration ([Ca2+]ext). A decreased sensitivity to [Ca2+]ext occurs in adenomatous parathyroid cells in patients with primary hyperparathyroidism, but the underlying functional mechanism is not yet fully understood. This study explored whether CaR responsiveness is influenced by increasing the affinity of IP3 receptors--a major signalling component of other G-protein-coupled receptors. The sulphydryl reagent thimerosal was used to increase the responsiveness of IP3-receptors. Quantitative fluorescence microscopy in Fura-2-loaded cells was used to investigate the effects of thimerosal on the cytoplasmic calcium concentrations ([Ca2+]i) in human parathyroid cells and to compare its effects in a rat medullary thyroid carcinoma cell line (rMTC6-23) also expressing CaR. During incubation in Ca(2+)-free medium, thimerosal 5 microM induced a rapid sustained rise in [Ca2+]i in human parathyroid cells and no further [Ca2+]i increase appeared in response to the CaR agonist Gd3+ (100 microM). Thimerosal 1 microM induced only slow and minimal changes of basal [Ca2+]i and allowed a rapid response to Gd3+ 20 nM (a concentration without effect in control cells). The slope of the thimerosal-induced [Ca2+]i responses was steeper following exposure to CaR agonists. In the presence of 1 mM [Ca2+]ext, thimerosal (0.5 microM) induced a sharp increase in [Ca2+]i to a peak (within 60 s), followed either by return to basal [Ca2+]i or by a plateau of slightly higher amplitude. Similar results were obtained using rMTC6-23 cells. Thimerosal increases the responsiveness to CaR agonists through modulation of the sensitivity of the IP3 receptor in both parathyroid and rMTC6-23 cells.     

Effect of Early Iron Deficiency in Rat on the γ-Aminobutyric Acid Shunt in Brain

Early iron deficiency in rat does not affect the weight or the protein, DNA, and RNA content but results in a slight reduction in gamma-aminobutyric acid (GABA) (13%, p less than 0.01) and glutamic acid (20%, p less than 0.001) content of the brain. The activities of the two GABA shunt enzymes, glutamate dehydrogenase and GABA-transaminase, and of the NAD+-linked isocitrate dehydrogenase (ICDH) were inhibited whereas the glutamic acid decarboxylase, mitochondrial NADP+-linked ICDH, and succinic dehydrogenase activities remained unaltered in brain. On rehabilitation with the iron-supplemented diet for 1 week, these decreased enzyme activities in brain attained the corresponding control values. However, the hepatic nonheme iron content increased to about 80% of the control, after rehabilitation for 2 weeks. A prolonged iron deficiency resulting in decreased levels of glutamate and GABA may lead to endocrinological, neurological, and behavioral alterations.