Molecular insights into the regulation of iron metabolism during the prenatal and early postnatal periods

Mouse hindlimb unloading, as a model of simulated microgravity, leads to dysregulated iron homeostasis in liver and skeletal muscle cells

Microgravity exposure can impact various physiological systems, yet its specific effects on liver cells remain inadequately studied. To address this gap, we used a hindlimb unloading (HU) mouse model to simulate microgravity conditions and investigate alterations in iron metabolism within liver and skeletal muscle cells. 16-week-old male C57BL/6j mice were divided into three groups: (i) ground-based control (GC), (ii) hindlimb unloading treated with vehicle (HU-v), and (iii) hindlimb unloading treated with deferoxamine (DFO). After three weeks, mice were euthanized, and samples of gastrocnemius muscle, liver, and serum were collected for analysis. The HU-v group exhibited significant muscle and liver cell atrophy compared to the GC group, along with disrupted iron metabolism, as indicated by altered expression of key iron regulatory proteins, including FTH1, FPN, TFR1, IRP-1, HMOX-1, and Hepcidin. In contrast, the DFO group demonstrated restored iron homeostasis, with protein expression patterns resembling those of the GC group. Serum analysis revealed elevated levels of serum iron, ferritin, and transferrin in the DFO group compared to both HU-v and GC groups, albeit with minimal changes in total iron-binding capacity. These findings suggest that simulated microgravity induces iron overload and cellular atrophy in liver and skeletal muscle cells, highlighting the potential therapeutic benefits of iron chelation in such conditions.

The natural diet composition of young piglets suggests an overlook of fibre and food structure in farmed suckling piglets

BACKGROUND

The often disappointing intake of creep feed by suckling piglets coincides with a limited ability to cope with challenges such as weaning diarrhoea. Investigating the dietary nutrient profile of piglets (Sus scrofa) in the wild may help to improve nutrition for farmed piglets. This study was conducted to analyse the stomach content of feral piglets and their farmed counterparts, and to compare them with the composition of commercial creep feeds. Forty feral piglets (4.6 ± 1.4 kg) living in a wild herd were tracked and legally hunted in the Bahía Samborombón (Buenos Aires, Argentina). Their gastric contents were collected for analysing macronutrients. Twenty-eight farmed suckling piglets of similar ages were sourced from a Dutch research farm, and their stomach contents were collected and pooled into fourteen samples with the same procedure for comparison. Additionally, the composition data of twenty-five commercial feeds was also collected.

RESULTS

A higher dry matter content was observed in the farmed piglets' stomachs (233 vs. 148 g/kg, P < 0.05). The gastric crude protein concentration was similar between both groups but the crude fat concentration was higher in the stomach of farmed animals (525 vs. 238 g/kg DM, P < 0.05), while feral piglets consumed more ash and fibre (P < 0.05). A similar concentration of non-fibrous carbohydrates (NFC) on metabolizable energy basis was observed by calculation through the NRC's guideline (P > 0.05). Within the fibre content, significantly greater concentrations of neutral detergent fiber (NDF), acid detergent fiber (ADF) and acid detergent lignin (ADL) were observed in the stomach of feral piglets than in those of farmed piglets (282 vs. 36 g/kg, 158 vs. 9 g/kg DM, 53 vs. 3 g/kg DM, respectively, P < 0.05). Similar protein concentrations were observed between the gastric content of feral piglets and creep feed, while significantly higher crude ash and crude fat concentrations were found in feral piglets' consumption (P < 0.05).

CONCLUSION

In conclusion, piglets in natural conditions consume much more fibre-from coarse plant material-compared to farmed piglets receiving creep feed. Although technical performance is distinctly different between nature and farm, it raises the question whether suckling piglets under farming conditions would benefit from a more fibrous and coarser creep feed.

Comparison of Molecular Potential for Iron Transfer across the Placenta in Domestic Pigs with Varied Litter Sizes and Wild Boars

Neonatal iron deficiency anemia is prevalent among domestic pigs but does not occur in the offspring of wild boar. The main causes of this disorder in piglets of modern pig breeds are paucity of hepatic iron stores, high birth weight, and rapid growth. Replenishment of fetal iron stores is a direct result of iron transfer efficiency across the placenta. In this study, we attempted to investigate the molecular potential of iron transfer across the placenta as a possible cause of differences between wild boar and Polish Large White (PLW) offspring. Furthermore, by analyzing placentas from PLW gilts that had litters of different sizes, we aimed to elucidate the impact of the number of fetuses on placental ability to transport iron. Using RNA sequencing, we examined the expression of iron-related genes in the placentas from wild boar and PLW gilts. We did not reveal significant differences in the expression of major iron transporters among all analyzed placentas. However, in wild boar placentas, we found higher expression of copper-dependent ferroxidases such as ceruloplasmin, zyklopen, and hephaestin, which facilitate iron export to the fetal circulation. We also determined a close co-localization of ceruloplasmin and zyklopen with ferroportin, the only iron exporter.

Iron Supplementation of Pregnant Sows to Prevent Iron Deficiency Anemia in Piglets: A Procedure of Questionable Effectiveness

In pigs, iron deficiency anemia (IDA) is a common disorder that occurs during the early postnatal period, leading to the stunted growth and increased mortality of piglets. The main cause of IDA is low iron stores in the liver of newborn piglets; these stores constitute the main source of iron needed to satisfy the erythropoietic requirements of the piglets in their first weeks of life. Insufficient iron stores in piglets are usually due to the inadequate placental iron transfer from the sow to the fetuses. Therefore, iron supplementation in pregnant sows has been implemented to enhance placental iron transfer and increase iron accumulation in the liver of the fetuses. Over the years, several oral and parenteral approaches have been attempted to supplement sows with various iron preparations, and consequently, to improve piglets' red blood cell indices. However, there is debate with regard to the effectiveness of iron supplementation in pregnant sows for preventing IDA in newborn piglets. Importantly, this procedure should be carried out with caution to avoid iron over-supplementation, which can lead to iron toxicity. This article aims to critically review and evaluate the use of iron supplementation in pregnant sows as a procedure for preventing IDA in piglets.

Iron homeostasis in full-term, normal birthweight Gambian neonates over the first week of life

Human neonates elicit a profound hypoferremia which may protect against bacterial sepsis. We examined the transience of this hypoferremia by measuring iron and its chaperone proteins, inflammatory and haematological parameters over the first post-partum week. We prospectively studied term, normal weight Gambian newborns. Umbilical cord vein and artery, and serial venous blood samples up to day 7 were collected. Hepcidin, serum iron, transferrin, transferrin saturation, haptoglobin, c-reactive protein, α1-acid-glycoprotein, soluble transferrin receptor, ferritin, unbound iron-binding capacity and full blood count were assayed. In 278 neonates we confirmed the profound early postnatal decrease in serum iron (22.7 ± 7.0 µmol/L at birth to 7.3 ± 4.6 µmol/L during the first 6-24 h after birth) and transferrin saturation (50.2 ± 16.7% to 14.4 ± 6.1%). Both variables increased steadily to reach 16.5 ± 3.9 µmol/L and 36.6 ± 9.2% at day 7. Hepcidin increased rapidly during the first 24 h of life (19.4 ± 14.4 ng/ml to 38.9 ± 23.9 ng/ml) and then dipped (32.7 ± 18.4 ng/ml) before rising again at one week after birth (45.2 ± 19.1 ng/ml). Inflammatory markers increased during the first week of life. The acute postnatal hypoferremia in human neonates on the first day of life is highly reproducible but transient. The rise in serum iron during the first week of life occurs despite very high hepcidin levels indicating partial hepcidin resistance.Trial Registration: clinicaltrials.gov (NCT03353051). Registration date: November 27, 2017.

Role of iron in the reduction of anemia among women of reproductive age in low-middle income countries: insights from systematic review and meta-analysis

BACKGROUND

Iron deficiency anemia is a common public health issue among women of reproductive age (WRA) because it can result in adverse maternal and birth outcomes. Although studies are undertaken to assess iron efficacy, some gaps and limitations in the existing literature need to be addressed. To fill the gaps, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the role of iron in reducing anemia among WRA in low-middle-income countries (LMICs).

METHODS

A comprehensive search strategy was used to search Medline through PubMed, Embase, and Science Direct for RCTs published between 2000 and 2020. The primary outcome was the mean change in hemoglobin level. We used standardized mean differences and their respective 95% CI to estimate the pooled effect. We used I² statistics and Egger's test to assess heterogeneity and publication bias, respectively. This review was carried out in accordance with revised guidelines based on the Preferred Reporting Items for Systematic Review and Meta-analysis.

RESULTS

The findings showed that iron therapy improved hemoglobin and ferritin levels, though the results varied across studies. An overall pooled effect estimate for the role of iron therapy in improving the hemoglobin levels among WRA was -0.71 (95% CI: -1.27 to -0.14) (p = 0.008). Likewise, the overall pooled effect estimate for the role of iron therapy in improving the ferritin levels among WRA was -0.76 (95% CI: -1.56 to 0.04) (p = 0.04). The heterogeneity (I²) across included studies was found to be statistically significant for studies assessing hemoglobin (Q = 746.93, I² = 97.59%, p = 0.000) and ferritin level (Q = 659.95, I² = 97.88%, p = 0.000).

CONCLUSION

Iron therapy in any form may reduce anemia's burden and improve hemoglobin and ferritin levels, indicating improvement in iron-deficiency anemia. More evidence is required, however, to assess the morbidity associated with iron consumption, such as side effects, work performance, economic outcomes, mental health, and adherence to the intervention, with a particular focus on married but non-pregnant women planning a pregnancy in the near future.

TRIAL REGISTRATION

Registered with PROSPERO and ID is CRD42020185033.

Broad misappropriation of developmental splicing profile by cancer in multiple organs

Oncogenesis mimics key aspects of embryonic development. However, the underlying mechanisms are incompletely understood. Here, we demonstrate that the splicing events specifically active during human organogenesis, are broadly reactivated in the organ-specific tumor. Such events are associated with key oncogenic processes and predict proliferation rates in cancer cell lines as well as patient survival. Such events preferentially target nitrosylation and transmembrane-region domains, whose coordinated splicing in multiple genes respectively affect intracellular transport and N-linked glycosylation. We infer critical splicing factors potentially regulating embryonic splicing events and show that such factors are potential oncogenic drivers and are upregulated specifically in malignant cells. Multiple complementary analyses point to MYC and FOXM1 as potential transcriptional regulators of critical splicing factors in brain and liver. Our study provides a comprehensive demonstration of a splicing-mediated link between development and cancer, and suggest anti-cancer targets including splicing events, and their upstream splicing and transcriptional regulators.

Shotgun and TMT-Labeled Proteomic Analysis of the Ovarian Proteins of an Insect Vector, Aedes aegypti (Diptera: Culicidae)

Aedes aegypti [Linnaeus in Hasselquist; yellow fever mosquito] transmits several viruses that infect millions of people each year, including Zika, dengue, yellow fever, chikungunya, and West Nile. Pathogen transmission occurs during blood feeding. Only the females blood feed as they require a bloodmeal for oogenesis; in the bloodmeal, holo-transferrin and hemoglobin provide the females with a high iron load. We are interested in the effects of the bloodmeal on the expression of iron-associated proteins in oogenesis. Previous data showed that following digestion of a bloodmeal, ovarian iron concentrations doubles by 72 hr. We have used shotgun proteomics to identify proteins expressed in Ae. aegypti ovaries at two oogenesis developmental stages following blood feeding, and tandem mass tag-labeling proteomics to quantify proteins expressed at one stage following feeding of a controlled iron diet. Our findings provide the first report of mosquito ovarian protein expression in early and late oogenesis. We identify proteins differentially expressed in the two oogenesis development stages. We establish that metal-associated proteins play an important role in Ae. aegypti oogenesis and we identify new candidate proteins that might be involved in mosquito iron metabolism. Finally, this work identified a unique second ferritin light chain subunit, the first reported in any species. The shotgun proteomic data are available via ProteomeXchange with identifier PXD005893, while the tandem mass tag-labeled proteomic data are available with identifier PXD028242.

Iron Metabolism in Normal and Pathological Pregnancies and Fetal Consequences

Iron is required for energy production, DNA synthesis, and cell proliferation, mainly as a component of the prosthetic group in hemoproteins and as part of iron-sulfur clusters. Iron is also a critical component of hemoglobin and plays an important role in oxygen delivery. Imbalances in iron metabolism negatively affect these vital functions. As the crucial barrier between the fetus and the mother, the placenta plays a pivotal role in iron metabolism during pregnancy. Iron deficiency affects 1.2 billion individuals worldwide. Pregnant women are at high risk of developing or worsening iron deficiency. On the contrary, in frequent hemoglobin diseases, such as sickle-cell disease and thalassemia, iron overload is observed. Both iron deficiency and iron overload can affect neonatal development. This review aims to provide an update on our current knowledge on iron and heme metabolism in normal and pathological pregnancies. The main molecular actors in human placental iron metabolism are described, focusing on the impact of iron deficiency and hemoglobin diseases on the placenta, together with normal metabolism. Then, we discuss data concerning iron metabolism in frequent pathological pregnancies to complete the picture, focusing on the most frequent diseases.

Comparative Evaluation of Sucrosomial Iron and Iron Oxide Nanoparticles as Oral Supplements in Iron Deficiency Anemia in Piglets

Iron deficiency is the most common mammalian nutritional disorder. However, among mammalian species iron deficiency anemia (IDA), occurs regularly only in pigs. To cure IDA, piglets are routinely injected with high amounts of iron dextran (FeDex), which can lead to perturbations in iron homeostasis. Here, we evaluate the therapeutic efficacy of non-invasive supplementation with Sucrosomial iron (SI), a highly bioavailable iron supplement preventing IDA in humans and mice and various iron oxide nanoparticles (IONPs). Analysis of red blood cell indices and plasma iron parameters shows that not all iron preparations used in the study efficiently counteracted IDA comparable to FeDex-based supplementation. We found no signs of iron toxicity of any tested iron compounds, as evaluated based on the measurement of several toxicological markers that could indicate the occurrence of oxidative stress or inflammation. Neither SI nor IONPs increased hepcidin expression with alterations in ferroportin (FPN) protein level. Finally, the analysis of the piglet gut microbiota indicates the individual pattern of bacterial diversity across taxonomic levels, independent of the type of supplementation. In light of our results, SI but not IONPs used in the experiment emerges as a promising nutritional iron supplement, with a high potential to correct IDA in piglets.

Novel edible toys as iron carrier to prevent iron deficiency of postweaned pigs

The current preventive treatment for iron deficiency in pigs is inefficient, resulting in a high prevalence of iron-deficient or anemic postweaned pigs. The aim of this study was to develop and characterize edible toys (ETs) to be used as oral iron supplements, and to assess their effect on feeding behavior and iron status of postweaned pigs. Three types of ETs, varying in sweetness, were produced by ionic gelation, using whey, sodium alginate, ferrous sulfate and atomized bovine erythrocytes. ET control (ETC) was developed without sweetener, ET1 contained 15% w/v sucrose and ET2 contained 0.03% w/v of Sucram (98% sodium saccharin, 1% neosperidine dihydrocalcone and 1% maltol). ETs were mainly composed of carbohydrates and protein, with a similar concentration of iron (2.2-2.7 mg/g). The ETs were offered to 24 postweaned pigs to measure acceptability and preference. The animals preferred ETC and ET2 over ET1. To assess the nutritional benefit of the ETs, 24 postweaned pigs were distributed into three groups: ETC (without iron), ETC-Fe (ETC with iron) and ET2-Fe (with iron and Sucram). Iron-loaded ET (ETC-Fe and ET2-Fe) significantly increased the concentration of red blood cells (from 6.1 to 7.5·10⁶ x mm³ for ETC-Fe and from 6.2 to 7.8 for ET2-Fe), hematocrit (from 32.8 to 37.9% for ETC-Fe and from 32.3 to 35.1 for ET2-Fe), serum iron (from 28.6 to 120.6 µmol/L for ETC-Fe and from 34.9 to 145.4 for ET2-Fe) and serum ferritin (from 7.8 to 18.5 µg/L for ETC-Fe and from 8.1 to 20.2 for ET2-Fe). In conclusion, the ETs developed in this study were accepted by the pigs and provided adequate iron to improve the iron status of postweaned pigs.

Marginally reduced maternal hepatic and splenic ferroportin under severe nutritional iron deficiency in pregnancy maintains systemic iron supply

The demand for iron is high in pregnancy to meet the increased requirements for erythropoiesis. Even pregnant females with initially iron‐replete stores develop iron‐deficiency anemia, due to inadequate iron absorption. In anemic females, the maternal iron supply is dedicated to maintaining iron metabolism in the fetus and placenta. Here, using a mouse model of iron deficiency in pregnancy, we show that iron recycled from senescent erythrocytes becomes a predominant source of this microelement that can be transferred to the placenta in females with depleted iron stores. Ferroportin is a key protein in the molecular machinery of cellular iron egress. We demonstrate that under iron deficiency in pregnancy, levels of ferroportin are greatly reduced in the duodenum, placenta and fetal liver, but not in maternal liver macrophages and in the spleen. Although low expression of both maternal and fetal hepcidin predicted ferroportin up‐regulation in examined locations, its final expression level was very likely correlated with tissue iron status. Our results argue that iron released into the circulation of anemic females is taken up by the placenta, as evidenced by high expression of iron importers on syncytiotrophoblasts. Then, a substantial decrease in levels of ferroportin on the basolateral side of syncytiotrophoblasts, may be responsible for the reduced transfer of iron to the fetus. As attested by the lowest decrease in iron content among analyzed tissues, some part is retained in the placenta. These findings confirm the key role played by ferroportin in tuning iron turnover in iron‐deficient pregnant mouse females and their fetuses.

Innovative oral sucrosomial ferric pyrophosphate-based supplementation rescues suckling piglets from iron deficiency anemia similarly to commonly used parenteral therapy with iron dextran

Iron deficiency is the most common mammalian nutritional deficiency during the neonatal period. However, among mammalian species neonatal iron deficiency anemia (IDA), the most severe consequence of iron scarcity, occurs regularly in pigs. Although intramuscular supplementation of piglets with high amounts of iron dextran (FeDex) is largely considered an appropriate preventive therapy for IDA prophylaxis, an increasing evidence shows that it negatively affects pig physiology. The aim of our study was to evaluate the efficacy of non-invasive supplementation of piglets with sucrosomial ferric pyrophosphate (SFP), a highly bioavailable dietary iron supplement in preventing IDA, in humans and mice. Results of our study show that SFP given to piglets per os in the amount of 6 mg Fe daily efficiently counteracts IDA at a rate comparable with the traditional FeDex-based supplementation (100 mgFe/kG b.w.; i.m. injection). This was indicated by physiological values of red blood cell indices and plasma iron parameters measured in 28-day old piglets. Moreover, SFP-supplemented piglets showed significantly lower (P ≤0.05) plasma level of 8-isoprostane, a biomarker for oxidative stress compared to FeDex-treated animals, implying lesser toxicity of this order of iron replenishment. Finally, supplementation with SFP does not increase considerably the blood plasma hepcidin, a peptide that acts to inhibit iron absorption from the diet. SFP emerges as a promising nutritional iron supplement, with a high potential to be adopted in the postnatal period.

Iron depletion with deferoxamine protects bone marrow-derived mesenchymal stem cells against oxidative stress-induced apoptosis

Bone marrow mesenchymal stem cells (BM-MSCs) are multipotent cells with self-renewal properties, making them an ideal candidate for regenerative medicine. Recently, numerous studies show that about more than 99% of transplanted cells are destroyed because of the stressful microenvironment. Meanwhile, in the target organs, iron overload can produce oxidative stress introducing it as the most important stress factor. The present study was aimed at increasing BM-MSCs' viability against oxidative stress microenvironment using iron depletion by deferoxamine (DFO). Mesenchymal stem cells are isolated and characterized from rat bone marrow. Then, the sensitivity of BM-MSCs against H2O2-induced oxidative stress was evaluated through half of the inhibitory concentration (IC50) estimation by using MTT assay. The maximum non-inhibitory concentration of DFO on BM-MSCs was determined. The next step was the comparison between DFO pre-treated BM-MSCs and untreated cells against H2O2-induced apoptosis. BM-MSCs were identified with morphologic and flow cytometry analysis. IC50 of H2O2 was determined as 0.55 mM at 4 h. Also, the maximum non-inhibitory concentration of DFO was ascertained as 5 μM at 48 h. Our results demonstrated that pretreatment with DFO significantly potentiates BM-MSCs against H2O2-induced oxidative stress which was confirmed by MTT assay, AO/EB double staining, DAPI staining, and activated caspase 3 quantification as well as western blot test. Expression of cleaved caspase 3 and pAKT/AKT ratio obviously demonstrated DFO can resist the cells against cytotoxicity. These findings may help to develop better stem cell culture medium for MSC-based cell therapy. Moreover, regulation of cell stress can be used in practical subjects.

Antianemic action of the iron (IV) clathrochelate complexes

Anemia is one of the most common non-contagious diseases of pigs. Modern antianemic drugs have several drawbacks, so finding new drugs is a pressing issue. We previously reported the results of preclinical studies of iron in rare high valence IV. This allowed us to determine, supplement, and generalize the data on clinical studies of the new drugs with the active substance iron (IV) clathrochelate. Therefore, we studied its antianemic effect on piglets. Experiments were carried out on piglets-analogues neonates, which were divided into three groups: control and two experimental groups. Piglets were kept with sows on suckling. For the purpose of prevention of iron deficiency anemia, the traditional solution of iron dextran was administered once intramuscularly to piglets of I control group. The aqueous solution of iron (IV) clathrochelate complexes was administered once intramuscularly to piglets of II experimental group. Iron (IV) clathrochelate complexes were dissolved in a solvent of rheopolyglucin and administered once intramuscularly to piglets of III experimental group. 1 mL of test solutions contained 100 mg of active substance. The investigative material were the samples of blood and serum of piglets, their liver and spleen. The experiment lasted during a 30-day period since the birth of the piglets. According to the results of the experiments, iron (IV) clatrochelate complexes which were dissolved in water for injection and rheopolyglucin had higher antianemic activity compared to the control. This is evidenced by the dynamics of probable changes in the number of erythrocytes, hemoglobin content and hematocrit, iron content in serum and its mass fraction in the blood, liver and spleen of piglets. The effectiveness of the action of iron (IV) clatrochelate complexes is demonstrated by the full supply of piglets with iron and its higher bioavailability.

Long-term Effect of Split Iron Dextran/Hemoglobin Supplementation on Erythrocyte and Iron Status, Growth Performance, Carcass Parameters, and Meat Quality of Polish Large White and 990 Line Pigs

Heme is an efficient dietary iron supplement applied in humans and animals to prevent iron deficiency anemia (IDA). We have recently reported that the use of bovine hemoglobin as a dietary source of heme iron efficiently counteracts the development of IDA in young piglets, which is the common problem in pig industry. Here, we used maternal Polish Large White and terminal sire breed (L990) pigs differing in traits for meat production to evaluate the long-term effect of split supplementation with intramuscularly administered small amount of iron dextran and orally given hemoglobin on hematological indices, iron status, growth performance, slaughter traits, and meat quality at the end of fattening. Results of our study show that in pigs of both breeds split supplementation was effective in maintaining physiological values of RBC and blood plasma iron parameters as well as growth performance, carcass parameters, and meat quality traits. Our results prove the effectiveness of split iron supplementation of piglets in a far-reach perspective.

Hepcidin, Serum Iron, and Transferrin Saturation in Full-Term and Premature Infants during the First Month of Life: A State-of-the-Art Review of Existing Evidence in Humans

Neonates regulate iron at birth and in early postnatal life. We reviewed literature from PubMed and Ovid Medline containing data on umbilical cord and venous blood concentrations of hepcidin and iron, and transferrin saturation (TSAT), in human neonates from 0 to 1 mo of age. Data from 59 studies were used to create reference ranges for hepcidin, iron, and TSAT for full-term-birth (FTB) neonates over the first month of life. In FTB neonates, venous hepcidin increases 100% over the first month of life (to reach 61.1 ng/mL; 95% CI: 20.1, 102.0 ng/mL) compared with umbilical cord blood (29.7 ng/mL; 95% CI: 21.1, 38.3 ng/mL). Cord blood has a high concentration of serum iron (28.4 μmol/L; 95% CI: 26.0, 31.1 μmol/L) and levels of TSAT (51.7%; 95% CI: 46.5%, 56.9%). After a short-lived immediate postnatal hypoferremia, iron and TSAT rebounded to approximately half the levels in the cord by the end of the first month. There were insufficient data to formulate reference ranges for preterm neonates.

Effect of Oral Supplementation of Healthy Pregnant Sows with Sucrosomial Ferric Pyrophosphate on Maternal Iron Status and Hepatic Iron Stores in Newborn Piglets

Simple Summary

In most mammals, including humans, the need for iron increases rapidly in the last period of pregnancy. Therefore, in compliance with World Health Organization (WHO) recommendations, iron supplementation has become a standard procedure even in healthy pregnant women although it carries the risk of iron toxicity and dysregulation of systemic iron homeostasis. Due to physiological and genomic similarities between swine and humans, pigs constitute an useful animal model in nutritional studies during pregnancy. Here, healthy pregnant sows were supplemented with sucrosomial ferric pyrophosphate (SFP), a new non-heme iron formulation, to study its effect on their iron metabolism and that of their progeny. In particular, we aimed at verifying whether supplementation of pregnant sows with SFP will increase the level of low hepatic iron stores in newborn piglets. Results of our study show that SFP does not significantly alter neither systemic iron homeostasis in pregnant sows, nor hepatic iron stores in newborn piglets, which can be used during neonatal period for the maintenance of hematological status. We hypothesize that supplemental iron given orally to pregnant sows is poorly transferred across the placenta.

Abstract

Background: The similarities between swine and humans in physiological and genomic patterns, as well as significant correlation in size and anatomy, make pigs an useful animal model in nutritional studies during pregnancy. In humans and pigs iron needs exponentially increase during the last trimester of pregnancy, mainly due to increased red blood cell mass. Insufficient iron supply during gestation may be responsible for the occurrence of maternal iron deficiency anemia and decreased iron status in neonates. On the other hand, preventive iron supplementation of non-anemic mothers may be of potential risk due to iron toxicity. Several different regimens of iron supplementation have been applied during pregnancy. The majority of oral iron supplementations routinely applied to pregnant sows provide inorganic, non-heme iron compounds, which exhibit low bioavailability and intestinal side effects. The aim of this study was to check, using pig as an animal model, the effect of sucrosomial ferric pyrophosphate (SFP), a new non-heme iron formulation on maternal and neonate iron and hematological status, placental transport and pregnancy outcome; Methods: Fifteen non-anemic pregnant sows were recruited to the experiment at day 80 of pregnancy and randomized into the non-supplemented group (control; n = 5) and two groups receiving oral iron supplementation—sows given sucrosomial ferric pyrophosphate, 60 mg Fe/day (SFP; n = 5) (SiderAL^®, Pisa, Italy) and sows given ferrous sulfate 60 mg Fe/day (Gambit, Kutno, Poland) (FeSO₄; n = 5) up to delivery (around day 117). Biological samples were collected from maternal and piglet blood, placenta and piglet tissues. In addition, data on pregnancy outcome were recorded.; Results: Results of our study show that both iron supplements do not alter neither systemic iron homeostasis in pregnant sows nor their hematological status at the end of pregnancy. Moreover, we did not detect any changes of iron content in the milk and colostrum of iron supplemented sows in comparison to controls. Neonatal iron status of piglets from iron supplemented sows was not improved compared with the progeny of control females. No statistically significant differences were found in average piglets weight and number of piglets per litter between animals from experimental groups. The placental expression of iron transporters varied depending on the iron supplement.

Dietary iron chelate for sows and effects on iron supplementation in piglets

In order to evaluate iron chelate in diets for sows during gestation and lactation and its effects on iron supplementation for piglets, a total of 50 pregnant sows in the third parity order were distributed according to a randomized block design with two treatments: diet without iron chelate supplementation (n=20); diet supplemented with 0.15% of iron chelate (n=30). The litters of sows were distributed into five different treatments: sows without iron chelate supplementation and piglets receiving intramuscular iron-dextran; sows without iron chelate supplementation and piglets receiving oral iron supplementation; sows supplemented with iron chelate and piglets receiving intramuscular iron-dextran; sows supplemented with iron chelate and piglets receiving oral iron supplementation; sows supplemented with iron chelate and piglets without iron supplementation. No influence of dietary supplementation of iron chelate was verified on the productive parameters of the sows. For the piglets, iron-dextran supplementation promoted higher weaning weight in comparison to non-supplemented piglets, although not differing to those received oral iron supplementation. Thus, iron chelate supplementation did not improve the productive parameters of sows, but it increased iron excretion in the feces, thus requiring iron supplementation for the piglets after birth.

Neonatal iron distribution and infection susceptibility in full term, preterm and low birthweight babies in urban Gambia: study protocol for an observational study

Background: Neonatal infection is the third largest cause of death in children under five worldwide.  Nutritional immunity is the process by which the host innate immune system limits nutrient availability to invading organisms. Iron is an essential micronutrient for both microbial pathogens and their mammalian hosts. Changes in iron availability and distribution have significant effects on pathogen virulence and on the immune response to infection. Our previously published data shows that, during the first 24 hours of life, full-term neonates have reduced overall serum iron. Transferrin saturation decreases rapidly from 45% in cord blood to ~20% by six hours post-delivery. Methods: To study neonatal nutritional immunity and its role in neonatal susceptibility to infection, we will conduct an observational study on 300 full-term normal birth weight (FTB+NBW), 50 preterm normal birth weight (PTB+NBW), 50 preterm low birth weight (PTB+LBW) and 50 full-term low birth weight (FTB+LBW), vaginally-delivered neonates born at Kanifing General Hospital, The Gambia. We will characterize and quantify iron-related nutritional immunity during the early neonatal period and use ex vivo sentinel bacterial growth assays to assess how differences in serum iron affect bacterial growth. Blood samples will be collected from the umbilical cord (arterial and venous) and at serial time points from the neonates over the first week of life. Discussion: Currently, little is known about nutritional immunity in neonates. In this study, we will increase understanding of how nutritional immunity may protect neonates from infection during the first critical days of life by limiting the pathogenicity and virulence of neonatal sepsis causing organisms by reducing the availability of iron. Additionally, we will investigate the hypothesis that this protective mechanism may not be activated in preterm and low birth weight neonates, potentially putting these babies at an enhanced risk of neonatal infection. Trial registration: clinicaltrials.gov ( NCT03353051) 27/11/2017.

Role of the kidneys in the redistribution of heme-derived iron during neonatal hemolysis in mice

Moderate intravascular hemolysis is a common condition in newborns. It is followed by the accumulation of bilirubin, which is a secondary product of the activity of heme oxygenase-1, an enzyme that catalyzes the breakdown of heme released from disrupted erythrocytes and taken up by hepatic macrophages. Although these cells are a major site of enzymatic heme breakdown in adults, we show here that epithelial cells of proximal tubules in the kidneys perform the functions of both heme uptake and catabolism in mouse neonates. A time-course study examining mouse pups during the neonatal period showed a gradual recovery from hemolysis, and concomitant decreases in the expression of heme-related genes and non-heme iron transporters in the proximal tubules. By adjusting the expression of iron-handling proteins in response to the disappearance of hemolysis in mouse neonates, the kidneys may play a role in the detoxification of iron and contribute to its recirculation from the primary urine to the blood.

Neonatal iron distribution and infection susceptibility in full term, preterm and low birthweight babies in urban Gambia: study protocol for an observational study

Background: Neonatal infection is the third largest cause of death in children under five worldwide.  Nutritional immunity is the process by which the host innate immune system limits nutrient availability to invading organisms. Iron is an essential micronutrient for both microbial pathogens and their mammalian hosts. Changes in iron availability and distribution have significant effects on pathogen virulence and on the immune response to infection. Our previously published data shows that, during the first 24 hours of life, full-term neonates have reduced overall serum iron. Transferrin saturation decreases rapidly from 45% in cord blood to ~20% by six hours post-delivery. Methods: To study neonatal nutritional immunity and its role in neonatal susceptibility to infection, we will conduct an observational study on 300 full-term normal birth weight (FTB+NBW), 50 preterm normal birth weight (PTB+NBW), 50 preterm low birth weight (PTB+LBW) and 50 full-term low birth weight (FTB+LBW), vaginally-delivered neonates born at Kanifing General Hospital, The Gambia. We will characterize and quantify iron-related nutritional immunity during the early neonatal period and use ex vivo sentinel bacterial growth assays to assess how differences in serum iron affect bacterial growth. Blood samples will be collected from the umbilical cord (arterial and venous) and at serial time points from the neonates over the first week of life. Discussion: Currently, little is known about nutritional immunity in neonates. In this study, we will increase understanding of how nutritional immunity may protect neonates from infection during the first critical days of life by limiting the pathogenicity and virulence of neonatal sepsis causing organisms by reducing the availability of iron. Additionally, we will investigate the hypothesis that this protective mechanism may not be activated in preterm and low birth weight neonates, potentially putting these babies at an enhanced risk of neonatal infection. Trial registration: clinicaltrials.gov ( NCT03353051) 27/11/2017.

Iron Oversupplementation Causes Hippocampal Iron Overloading and Impairs Social Novelty Recognition in Nursing Piglets

BACKGROUND

Iron oversupplementation in healthy term infants may adversely affect growth and cognitive development.

OBJECTIVE

We hypothesized that early-life iron excess causes systemic and central nervous system iron overload, and compromises social behavior.

METHODS

The nursing pig was used as a translational model in a completely randomized study. On postnatal day (PD) 1, 24 pigs (1.57 ± 0.28 kg mean ± standard deviation body wt) were assigned to the following treatment groups: 1) nonsupplemented iron-deficient group (NON); 2) control group (CON), intramuscularly injected with iron dextran (100 mg Fe) on PD2; 3) moderate iron group (MOD), orally administered ferrous sulfate at 10 mg Fe · kg body wt-1 · d-1; and 4) high iron group (HIG), orally administered ferrous sulfate at 50 mg Fe · kg-1 · d-1. Piglets were nursed by sows during the study from PD1 to PD21. Tissue iron was analyzed by atomic absorption spectrophotometry. Messenger RNA and protein expression of iron regulator and transporters were analyzed by quantitative reverse transcriptase-polymerase chain reaction and Western blot. A sociability test was performed on PD19-20.

RESULTS

Both MOD and HIG treatments (5.51 and 9.85 µmol/g tissue), but not CON (0.54 µmol/g), increased hepatic iron as compared with NON (0.25 µmol/g, P < 0.05). Similarly, the hippocampal iron concentrations in the MOD and HIG groups were 14.9% and 31.8% higher than that of NON, respectively (P < 0.05). In comparison with NON, MOD and HIG treatment repressed DMT1 in duodenal mucosa by 4- and 46-fold, respectively (P < 0.05); HIG drastically induced HAMP in liver by 540-fold (P < 0.05); iron-supplemented groups reduced TFRC in the hippocampus by <1-fold (P < 0.05). However, duodenal expression of ferroportin, the predominant transporter in basal membrane, was not affected by treatment. Despite normal sociability, the MOD and HIG pigs displayed deficits in social novelty recognition (P = 0.004).

CONCLUSIONS

Duodenal ferroportin was hyporesponsive to iron excess (MOD and HIG), which caused hippocampal iron overload and impaired social novelty recognition in nursing pigs.

Use of Encapsulation Technology to Improve the Efficiency of an Iron Oral Supplement to Prevent Anemia in Suckling Pigs

Simple Summary

In animal nutrition, encapsulation technologies have been poorly explored, even though they may improve oral iron supplementation in suckling pigs. We hypothesized that the encapsulation of an oral supplement could enhance iron bioavailability for suckling pigs. We compared the levels of biomarkers for iron nutritional status among three groups of animals: piglets receiving oral encapsulated supplements, individuals receiving oral non-encapsulated supplements (as control group), and animals who were supplemented by parenteral route (strategy currently used in pig production systems). All treatments prevented anemia at weaning; however, only oral treatments prevented the first stage of anemia, which is iron depletion. In conclusion, piglets supplemented with encapsulated iron showed a higher concentration of serum ferritin and, therefore, had better iron reserves.

Abstract

The objective of this study was to develop an encapsulated iron supplement for oral ingestion and to determine its effect on the iron nutrition status of suckling pigs. Encapsulated and non-encapsulated iron supplement was prepared. Seventy-two neonatal piglets were assigned to three experimental groups: (1) parenteral group (gold standard treatment), which received one dose of parenteral iron (200 mg), 2 days of age, (2) “non-encapsulated” group (as a control group), which received 4 oral doses of unencapsulated iron supplement at 2, 7, 12 and 17 days of age, and (3) “encapsulated” group, which received 4 oral doses of encapsulated iron supplement on the same days. The encapsulated and unencapsulated iron supplements contained 65.2 and 65.0 mg/iron/dose, respectively. Parenteral treatment was not sufficient to ensure an adequate iron nutritional state in piglets at the end of the lactation period, showing iron depletion (serum ferritin: 8.4 µg/L). In contrast, oral supplementation prevented the development of iron depletion. Higher serum ferritin values were observed in the encapsulated (19.9 µg/L) compared to the unencapsulated group (17.4 µg/L) (p = 0.020). In conclusion, the use of four oral doses of an encapsulated iron supplement prevents iron deficiency anemia and its previous stages in suckling pigs.

Iron Supplementation in Suckling Piglets: An Ostensibly Easy Therapy of Neonatal Iron Deficiency Anemia

In pigs, iron deficiency anemia (IDA) is the most prevalent deficiency disorder during the early postnatal period, frequently developing into a serious illness. On the other hand, in humans, only low-birth-weight infants, including premature infants, are especially susceptible to developing IDA. In both human and pig neonates, the initial cause of IDA is low birth iron stores. In piglets this shortage of stored iron results mainly from genetic selection over the past few decades for large litter sizes and high birth weights. As a consequence, pregnant sows cannot provide a sufficient amount of iron to the increasing number of developing fetuses. Supplementation with iron is a common practice for the treatment of IDA in piglets. For decades, the preferred procedure for delivering iron supplements during early life stages has been through the intramuscular injection of a large amount of iron dextran. However, this relatively simple therapy, which in general, efficiently corrects IDA, may generate toxic effects, and by inducing hepcidin expression, may decrease bioavailability of supplemental iron. New iron supplements are considered herein with the aim to combine the improvement of hematological status, blunting of hepcidin expression, and minimizing the toxicity of the administered iron. We propose that iron-deficient piglets constitute a convenient animal model for performing pre-clinical studies with iron supplements.

High levels of iron supplementation prevents neural tube defects in the Fpn1ffe mouse model

BACKGROUND

Periconception maternal nutrition and folate in particular are important factors influencing the incidence of neural tube defects (NTDs). Many but not all NTDs are prevented by folic acid supplementation and there is a pressing need for additional strategies to prevent these birth defects. Other micronutrients such as iron are potential candidates, yet a clear role for iron deficiency in contributing to NTDs is lacking. Our previous studies with the flatiron (ffe) mouse model of Ferroportin1 (Fpn1) deficiency suggest that iron is required for neural tube closure and forebrain development raising the possibility that iron supplementation could prevent NTDs.

METHODS

We determined the effect of periconception iron and/or folic acid supplementation on the penetrance of NTDs in the Fpn1^ffe mouse model. Concurrently, measurements of folate and iron were made to ensure supplementation had the intended effects.

RESULTS

High levels of iron supplementation significantly reduced the incidence of NTDs in Fpn1^ffe mutants. Fpn1 deficiency resulted in reduced folate levels in both pregnant dams and embryos. Yet folic acid supplementation did not prevent NTDs in the Fpn1^ffe model. Similarly, forebrain truncations were rescued with iron. Surprisingly, the high levels of iron supplementation used in this study caused folate deficiency in wild-type dams and embryos.

CONCLUSION

Our results demonstrate that iron supplementation can prevent NTDs and forebrain truncations in the Fpn1^ffe model. Surprisingly, high levels of iron supplementation and iron overload can cause folate deficiency. If iron is essential for neural tube closure, it is possible that iron deficiency might contribute to NTDs. Birth Defects Research 109:81-91, 2017. © 2016 The Authors Birth Defects Research Published by Wiley Periodicals, Inc.

Oral iron administration in suckling piglets – a review

Iron deficiency is presently a serious problem in suckling piglets on pig farms. The most often used method of anaemia prevention in piglets is parenteral administration of iron dextran. Oral iron represents an alternative to this method. The goal of this article is to review current knowledge on oral iron administration in suckling piglets. The substances that can be used for this purpose include iron dextran, iron salts, iron chelates, carbonyl iron, an iron polymaltose complex and iron microparticles. The different methods of oral iron administration in piglets are discussed.

Rhodamine based turn-on chemosensor for Fe3+ in aqueous medium and interactions of its Fe3+ complex with DNA

A novel di-coordinating rhodamine-based chemosensor, HL with NO donor atoms, selectively and rapidly recognizes Fe³⁺ in the presence of all biologically relevant as well as toxic metal ions and numerous anions and also with other reactive oxygen and nitrogen species.

Description of a Second Ferritin Light Chain Homologue From the Yellow Fever Mosquito (Diptera: Culicidae)

Ferritin is required for iron storage in vertebrates and for iron transport and storage in invertebrates, specifically insects. Classical ferritins consist of 24 subunits configured as a polyhedron wherein iron is held. The 24 subunits include light and heavy chains, each with specific functions. Several homologues of the light and heavy chains have been sequenced and studied in insects. In addition to iron transport and storage, ferritin has a role in dietary iron absorption, and functions as a protective agent preventing iron overload, decreasing oxidative stress, and reducing infection in these animals. The expression profile and regulation of a second ferritin light chain homologue (LCH2) in Aedes aegypti [Linnaeus (Diptera: Culicidae), yellow fever mosquito] was characterized in cells, animal developmental stages, and tissues post bloodmeal (PBM) by real-time PCR and immunoblot. Two previously studied ferritin subunits from Ae. aegypti, HCH and LCH1, along with LCH2 were immunoprecipitated and analyzed by mass spectrometry. The three Ae. aegypti ferritin subunits, HCH, LCH1, and LCH2, have different expression profiles and regulation with iron exposure, developmental stage, and tissue response PBM. Ae. aegypti expresses multiple and unique ferritin light chain subunits. Ae. aegypti, the vector for Zika, Dengue, and yellow fever, requires iron for oogenesis that is transported and stored in ferritin; this vector expresses a second light chain ferritin subunit homologue unlike any other species in which ferritin has been studied to date.

Anemia and Dental Caries in Pregnant Women: a Prospective Cohort Study

The objective was to evaluate the effect of anemia during pregnancy on the risk of dental caries development in pregnant women. A prospective cohort including a sample of pregnant women in a prenatal care unit of São Luís, Brazil, was done. The incidence of dental caries during pregnancy, according to Nyvad's criteria, was the outcome. The main independent variables were serum iron, ferritin, hemoglobin, erythrocyte, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW). Pregnant women (n = 121) were evaluated at two moments: up to 16th week of gestational age (T1) and in the last trimester of pregnancy (T2). Crude and adjusted associations were estimated by the incidence ratio risk (IRR) and respective 95% confidence intervals (95%CI). After adjustment, higher serum concentrations of ferritin (IRR = 0.97, 95%CI 0.95-0.99) in T1, and Fe (IRR = 0.99, 95%CI 0.98-0.99), ferritin (IRR = 0.99, 95%CI 0.98-0.99), erythrocyte (IRR = 0.71, 95%CI 0.50-0.99), hemoglobin (IRR = 0.84, 95%CI 0.73-0.96), hematocrit (IRR = 0.93, 95%CI 0.88-0.98), MCV (IRR = 0.91, 95%CI 0.86-0.96), and MCH (IRR = 0.83, 95%CI 0.74-0.93) in T2, were associated with fewer incidence of dental caries in pregnant women. Iron deficiency anemia during pregnancy is a risk factor for the incidence of dental caries in these women.

Effects of different iron supply to pregnant sows (Sus scrofa domestica L.) on reproductive performance as well as iron status of new-born piglets

The present study aimed to investigate the effects of different iron (Fe) supply to sows during gestation on their reproductive performance and placental Fe load. Additionally, the Fe status of the corresponding offspring was assessed. Twenty multiparous sows were fed from insemination to farrowing with isoenergetic and isonitrogenic balanced diets differing in Fe content. The diet low in Fe (Group -Fe) was mainly composed of soybean meal and maize meal and had a Fe content of 114 mg/kg DM. For the diet high in Fe (Group +Fe), the diet was supplemented with Fe(II)SO₄ · 7H₂O to a total Fe content of 256 mg/kg. Blood characteristics (haemoglobin, haematocrit, mean corpuscular haem concentration, total Fe-binding capacity, transferrin saturation) of all sows were measured at the beginning and at the end of gestation. Daily Fe retention was calculated at the day of farrowing. After birth, reproductive performance (litter size, piglet weight, litter weight), placental Fe content and Fe blood characteristics of the piglets were determined. Apparent daily Fe retention tended to be greater in Group +Fe (p < 0.1). Blood parameters of the sows did not show any variations between feeding groups, neither at the beginning nor at the end of pregnancy, whereas placental Fe content was lower in Group -Fe (p < 0.05). In addition, Fe supply during gestation improved litter size (p < 0.01) and litter weight (p < 0.05). Although all sows were supplied according to the current Fe recommendations, a significant decline in reproductive performance of Group -Fe was recognised. Therefore, it was concluded that the re-evaluation of the gross Fe requirements of pregnant sows is inevitable to accommodate the current feeding recommendations.

A rhodamine based turn-on chemosensor for Fe3+ in aqueous medium and interactions of its Fe3+ complex with HSA

A novel hexa-coordinating rhodamine-based chemosensor, HL6, selectively and rapidly recognizes Fe³⁺ in the presence of a number of metal cations, numerous anions and amino acids in purely aqueous medium with live cell imaging applications.

Maternal and Cord Blood Hepcidin Concentrations in Severe Iron Deficiency Anemia

BACKGROUND

The present study was conducted to assess the maternal and cord blood hepcidin concentrations in severe iron deficiency anemia (IDA) and to find out its correlation with other iron status parameters.

METHODS

This prospective observational study was carried out in 30 mothers with severe IDA (hemoglobin < 70 g/L and serum ferritin < 12 μg/L), and 15 healthy nonanemic (hemoglobin ≥ 110 g/L) mothers, who delivered live singleton neonates at term gestation. Mothers and neonates with infection/inflammatory conditions were excluded. Quantitative estimation of complete blood count, serum iron, ferritin, total iron binding capacity (TIBC), and transferrin saturation (Tfsat) was done in maternal and cord blood immediately after delivery by an auto analyzer. Serum hepcidin concentrations were measured by double-antibody sandwich enzyme-linked immunosorbent assay using a Human Hepcidin-25 kit. Data were analyzed by statistical software SPSS 16.0.

RESULTS

The serum iron and ferritin concentrations in severe IDA were 6.7 ± 1.8 μmol/L and 4.1 ± 1.4 μg/L in maternal blood, and 9.5 ± 2.6 μmol/L and 55.4 ± 19.7 μg/L in cord blood, respectively, significantly lower than nonanemic controls (p < 0.001). The corresponding serum hepcidin concentrations were 76.6 ± 22.7 μg/L and 110.5 ± 11.8 μg/L, respectively (p < 0.05). The proportion of cord blood/maternal blood hepcidin concentration was similar in both anemic (1.4:1) and nonanemic (1.3:1) mothers. Significant correlation was observed among maternal and cord blood hepcidin concentrations and other iron status parameters.

CONCLUSION

Even in the presence of low serum iron and ferritin, maternal and cord blood hepcidin concentrations remained high in severe anemia. Failure of this proportional suppression of hepcidin indicates poor systemic bioavailability of iron to the mother and poor placental transport.

Mottled Mice and Non-Mammalian Models of Menkes Disease

Menkes disease is a multi-systemic copper metabolism disorder caused by mutations in the X-linked ATP7A gene and characterized by progressive neurodegeneration and severe connective tissue defects. The ATP7A protein is a copper (Cu)-transporting ATPase expressed in all tissues and plays a critical role in the maintenance of copper homeostasis in cells of the whole body. ATP7A participates in copper absorption in the small intestine and in copper transport to the central nervous system (CNS) across the blood-brain-barrier (BBB) and blood–cerebrospinal fluid barrier (BCSFB). Cu is essential for synaptogenesis and axonal development. In cells, ATP7A participates in the incorporation of copper into Cu-dependent enzymes during the course of its maturation in the secretory pathway. There is a high degree of homology (>80%) between the human ATP7A and murine Atp7a genes. Mice with mutations in the Atp7a gene, called mottled mutants, are well-established and excellent models of Menkes disease. Mottled mutants closely recapitulate the Menkes phenotype and are invaluable for studying Cu-metabolism. They provide useful models for exploring and testing new forms of therapy in Menkes disease. Recently, non-mammalian models of Menkes disease, Drosophila melanogaster and Danio rerio mutants were used in experiments which would be technically difficult to carry out in mammals.

Pre-weaning dietary iron deficiency impairs spatial learning and memory in the cognitive holeboard task in piglets

Iron deficiency is the most common nutritional deficiency in humans, affecting more than two billion people worldwide. Early-life iron deficiency can lead to irreversible deficits in learning and memory. The pig represents a promising model animal for studying such deficits, because of its similarities to humans during early development. We investigated the effects of pre-weaning dietary iron deficiency in piglets on growth, blood parameters, cognitive performance, and brain histology later in life. Four to six days after birth, 10 male sibling pairs of piglets were taken from 10 different sows. One piglet of each pair was given a 200 mg iron dextran injection and fed a control milk diet for 28 days (88 mg Fe/kg), whereas the other sibling was given a saline injection and fed an iron deficient (ID) milk diet (21 mg Fe/kg). Due to severely retarded growth of two of the ID piglets, only eight ID piglets were tested behaviorally. After dietary treatment, all piglets were fed a balanced commercial pig diet (190-240 mg Fe/kg). Starting at 7.5 weeks of age, piglets were tested in a spatial cognitive holeboard task. In this task, 4 of 16 holes contain a hidden food reward, allowing measurement of working (short-term) memory and reference (long-term) memory (RM) simultaneously. All piglets received 40-60 acquisition trials, followed by a 16-trial reversal phase. ID piglets showed permanently retarded growth and a strong decrease in blood iron parameters during dietary treatment. After treatment, ID piglets' blood iron values restored to normal levels. In the holeboard task, ID piglets showed impaired RM learning during acquisition and reversal. Iron staining at necropsy at 12 weeks of age showed that ID piglets had fewer iron-containing cells in hippocampal regions CA1 and dentate gyrus (DG). The number of iron-containing cells in CA3 correlated positively with the average RM score during acquisition across all animals. Our results support the hypothesis that early-life iron deficiency leads to lasting cognitive deficits. The piglet as a model animal, tested in the holeboard, can be useful in future research for assessing long-term cognitive effects of early-life diets or diet-induced deficiencies.

An Overview of Iron in Term Breast-Fed Infants

BACKGROUND

Iron is an essential nutrient for normal growth and neurodevelopment of infants. Iron deficiency (ID) remains the most common micronutrient deficiency worldwide. There are convincing data that ID is associated with negative effects on neurological and psychomotor development.

OBJECTIVES

In this review, we provide an overview of current knowledge of the importance of iron in normal term breast-fed infants with a focus on recommendations, metabolism, and iron requirements.

CONCLUSIONS

Health organizations around the world recommend the introduction of iron-rich foods or iron supplements for growing infants to prevent ID. However, there is no routine screening for ID in infancy. Multicenter trials with long-term follow-up are needed to investigate the association between iron fortification/supplementation and various health outcomes.

The importance of hemosiderin deposition in the infant brain: an autopsy study

BACKGROUND/AIM

Iron is an essential element involved in many metabolic processes. Presence and accumulation of iron in various body systems can result in different outcomes. Its accumulation in the central nervous system (CNS) cannot be detected routinely by application of hematoxylin-eosin staining. Detection of the presence of hemosiderin in the brain and cerebellum by application of Perls' dye is of importance in cases of infant deaths.

MATERIAL AND METHODS

In this study, brain and cerebellar specimens obtained from 52 eligible infants  (aged 0-1 years) autopsied in our institute between the years 2010 and 2013, independent of the cause of death, were analyzed in order to detect possible presence of hemosiderin. Perls' dye was used to detect histopathological staining intensity and distribution of hemosiderin in the brain and cerebellum.

RESULTS

Cases did not differ significantly as for the patients' age and gender (p =0.473), type of the culprit trauma (p =0.414), death/crime scene (p =0.587), and diagnosis groups (p =0.550). In this autopsy study blue colored hemosiderin granulations, stained with Perls' dye were detected in the brain (n: 39, 75%), and cerebellum (n: 35, 67.3%). A weakly negative, but significant correlation was detected between the postmortem interval and intensity values of cerebellar hemosiderin (Spearman's correlation coefficient: -0.381, p =0.024). A statistically significant difference was found between the distribution scores of cerebral hemosiderin in cases with and without trauma history (p =0.03). Median cerebral hemosiderin distribution scores were 2.5 and 2, respectively.

CONCLUSIONS

The detection of a correlation between the presence of cerebral and cerebellar hemosiderin, and postmortem interval in the age group of 0-1 years, should be interpreted as an important finding in the analysis of cerebral iron. The presence of hemosiderin in the CNS may be a significant finding in the elucidation of infant deaths and this procedure should be carried out on a routine basis.Hippokratia 2015; 19 (2):164-171.

A review of the impact of dietary intakes in human pregnancy on infant birthweight

Studies assessing maternal dietary intakes and the relationship with birthweight are inconsistent, thus attempting to draw inferences on the role of maternal nutrition in determining the fetal growth trajectory is difficult. The aim of this review is to provide updated evidence from epidemiological and randomized controlled trials on the impact of dietary and supplemental intakes of omega-3 long-chain polyunsaturated fatty acids, zinc, folate, iron, calcium, and vitamin D, as well as dietary patterns, on infant birthweight. A comprehensive review of the literature was undertaken via the electronic databases Pubmed, Cochrane Library, and Medline. Included articles were those published in English, in scholarly journals, and which provided information about diet and nutrition during pregnancy and infant birthweight. There is insufficient evidence for omega-3 fatty acid supplements’ ability to reduce risk of low birthweight (LBW), and more robust evidence from studies supplementing with zinc, calcium, and/or vitamin D needs to be established. Iron supplementation appears to increase birthweight, particularly when there are increases in maternal hemoglobin concentrations in the third trimester. There is limited evidence supporting the use of folic acid supplements to reduce the risk for LBW; however, supplementation may increase birthweight by ~130 g. Consumption of whole foods such as fruit, vegetables, low-fat dairy, and lean meats throughout pregnancy appears beneficial for appropriate birthweight. Intervention studies with an understanding of optimal dietary patterns may provide promising results for both maternal and perinatal health. Outcomes from these studies will help determine what sort of dietary advice could be promoted to women during pregnancy in order to promote the best health for themselves and their baby.

Antenatal iron-folic acid supplementation reduces risk of low birthweight in Pakistan: secondary analysis of Demographic and Health Survey 2006-2007

The aim of the current study was to examine the impact of antenatal iron-folic acid (IFA) supplementation on perceived birth size and birthweight in Pakistan over a 5-year period from 2002 to 2006. The data source was the Pakistan Demographic and Health Survey (PDHS) 2006-2007. Information from 5692 most recent live-born infants within 5 years prior to the survey was examined. The primary outcomes were maternal perception of birth size and birthweight, and the main exposure was any use of antenatal IFA supplements. Birthweight was reported for only 10% of the live births in the PDHS 2006-2007. Multivariate logistic regression analysis was adjusted for the cluster sampling design and for 13 potential confounders. The risk of having smaller than average birth size newborn was significantly reduced by 18% (adjusted odds ratio 0.82, 95% confidence interval 0.71, 0.96) for mothers who used any IFA supplements compared with those who did not. A similar (18%), but non-significant reduction in the risk of low birthweight, was found with the maternal use of IFA supplements. The risk of having smaller than average birth size babies was significantly reduced by 19% in those women who started IFA in the first trimester of pregnancy. About 11% of babies with smaller than average birth size were attributed to non-use of antenatal IFA supplements. Antenatal IFA supplementation significantly reduces the risk of a newborn of smaller than average birth size in Pakistan. Universal coverage of supplementation would improve birth size.

Effects of iron supplements and perinatal factors on fetal hemoglobin disappearance in LBW infants

BACKGROUND

The homeostatic mechanisms of iron metabolism and erythropoiesis in infants are unclear. Infants synthesize both fetal hemoglobin (HbF) and adult hemoglobin (HbA), and it is not known how the hemoglobin switch is regulated. We hypothesized that iron supplements to infants affect the disappearance of HbF.

METHODS

We randomized 285 low-birth-weight infants (2,000-2,500 g) into three intervention groups receiving 0, 1, or 2 mg/kg/d of iron supplements from 6 wk to 6 mo of age. In the present secondary analysis, we analyzed iron status, total hemoglobin (Hb), and HbF fraction at 6 wk, 12 wk, and at 6 mo and calculated absolute levels of HbF.

RESULTS

We observed dose-dependent increased levels of Hb in iron-supplemented groups at 6 mo of age. However, for absolute HbF concentration, there was no similar effect of intervention. Mean (SD) HbF was 81.2 (16.8), 37.0 (13.8), and 8.1 (5.6) g/l at 6 wk, 12 wk, and 6 mo, respectively, similar in all groups. In linear regression analyses, postconceptional age turned out as the major predictor of HbF, independent of gestational age at birth.

CONCLUSION

Our hypothesis was rejected. Instead, we confirmed a close correlation to postconceptional age, supporting a genetically programmed switch, insensitive to most environmental factors including birth.

Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis

OBJECTIVES

To summarise evidence on the associations of maternal anaemia and prenatal iron use with maternal haematological and adverse pregnancy outcomes; and to evaluate potential exposure-response relations of dose of iron, duration of use, and haemoglobin concentration in prenatal period with pregnancy outcomes.

DESIGN

Systematic review and meta-analysis

DATA SOURCES

Searches of PubMed and Embase for studies published up to May 2012 and references of review articles.

STUDY SELECTION CRITERIA

Randomised trials of prenatal iron use and prospective cohort studies of prenatal anaemia; cross sectional and case-control studies were excluded.

RESULTS

48 randomised trials (17 793 women) and 44 cohort studies (1 851 682 women) were included. Iron use increased maternal mean haemoglobin concentration by 4.59 (95% confidence interval 3.72 to 5.46) g/L compared with controls and significantly reduced the risk of anaemia (relative risk 0.50, 0.42 to 0.59), iron deficiency (0.59, 0.46 to 0.79), iron deficiency anaemia (0.40, 0.26 to 0.60), and low birth weight (0.81, 0.71 to 0.93). The effect of iron on preterm birth was not significant (relative risk 0.84, 0.68 to 1.03). Analysis of cohort studies showed a significantly higher risk of low birth weight (adjusted odds ratio 1.29, 1.09 to 1.53) and preterm birth (1.21, 1.13 to 1.30) with anaemia in the first or second trimester. Exposure-response analysis indicated that for every 10 mg increase in iron dose/day, up to 66 mg/day, the relative risk of maternal anaemia was 0.88 (0.84 to 0.92) (P for linear trend<0.001). Birth weight increased by 15.1 (6.0 to 24.2) g (P for linear trend=0.005) and risk of low birth weight decreased by 3% (relative risk 0.97, 0.95 to 0.98) for every 10 mg increase in dose/day (P for linear trend<0.001). Duration of use was not significantly associated with the outcomes after adjustment for dose. Furthermore, for each 1 g/L increase in mean haemoglobin, birth weight increased by 14.0 (6.8 to 21.8) g (P for linear trend=0.002); however, mean haemoglobin was not associated with the risk of low birth weight and preterm birth. No evidence of a significant effect on duration of gestation, small for gestational age births, and birth length was noted.

CONCLUSIONS

Daily prenatal use of iron substantially improved birth weight in a linear dose-response fashion, probably leading to a reduction in risk of low birth weight. An improvement in prenatal mean haemoglobin concentration linearly increased birth weight.

IRP1 regulates erythropoiesis and systemic iron homeostasis by controlling HIF2α mRNA translation

Hypoxia inducible factor 2α (HIF2α) transcriptionally activates several genes in response to hypoxia. Under normoxic conditions, it undergoes oxygen-dependent degradation by the prolyl hydroxylase (PHD)/von Hippel-Lindau (VHL) system. The presence of an iron-responsive element (IRE) within the 5' untranslated region of HIF2α mRNA suggests a further iron- and oxygen-dependent mechanism for translational regulation of its expression via iron regulatory proteins 1 and 2 (IRP1 and IRP2, respectively). We show here that the disruption of mouse IRP1, but not IRP2, leads to profound HIF2α-dependent abnormalities in erythropoiesis and systemic iron metabolism. Thus, 4- to 6-week-old IRP1(-/-) mice exhibit splenomegaly and extramedullary hematopoiesis, which is corrected in older animals. These erythropoietic abnormalities are caused by translational de-repression of HIF2α mRNA and subsequent accumulation of HIF2α, which induces expression of erythropoietin (Epo). Increased levels of circulating Epo lead to reticulocytosis, polycythemia, and suppression of hepatic hepcidin mRNA. This in turn promotes hyperferremia and iron depletion in splenic macrophages due to unrestricted expression of ferroportin. Our data demonstrate that IRP1 is the principal regulator of HIF2α mRNA translation in vivo and provide evidence that translational control of HIF2α expression dominates over PHD/VHL-mediated regulation of HIF2α stability in juvenile IRP1(-/-) mice.

Iron supplementation in suckling piglets: how to correct iron deficiency anemia without affecting plasma hepcidin levels

The aim of the study was to establish an optimized protocol of iron dextran administration to pig neonates, which better meets the iron demand for erythropoiesis. Here, we monitored development of red blood cell indices, plasma iron parameters during a 28-day period after birth (till the weaning), following intramuscular administration of different concentrations of iron dextran to suckling piglets. To better assess the iron status we developed a novel mass spectrometry assay to quantify pig plasma levels of the iron-regulatory peptide hormone hepcidin-25. This hormone is predominantly secreted by the liver and acts as a negative regulator of iron absorption and reutilization. The routinely used protocol with high amount of iron resulted in the recovery of piglets from iron deficiency but also in strongly elevated plasma hepcidin-25 levels. A similar protocol with reduced amounts of iron improved hematological status of piglets to the same level while plasma hepcidin-25 levels remained low. These data show that plasma hepcidin-25 levels can guide optimal dosing of iron treatment and pave the way for mixed supplementation of piglets starting with intramuscular injection of iron dextran followed by dietary supplementation, which could be efficient under condition of very low plasma hepcidin-25 level.