Effects of different doses and duration of iron supplementation on curing iron deficiency anemia: an experimental study

Changes of metabolic parameters, antioxidant capacity, and gut microbiota in response to substitution of ferrous sulfate with iron hydroxy methionine analog chelate in weaned piglets

Introduction

Previous studies have suggested that dietary organic iron offers health advantages compared to its inorganic counterpart. However, the effects of iron hydroxy methionine analog chelate (Fe-HMA) supplementation in weaned piglets have not been fully explored. Therefore, this study aimed to investigate the effects of replacing ferrous sulfate with Fe-HMA as the iron source on serum biochemistry, antioxidant capacity, and gut microbiota in weaned piglets.

Methods

One hundred and twenty weaned piglets were randomly allocated to two treatment groups. Each group contained four replicates, with 15 pigs per replicate. Piglets were fed either 100 mg Fe/kg in the form of ferrous sulfate (Fe-sulfate group) or 50 mg Fe/kg in the form of Fe-HMA (Fe-HMA group) as the iron source for 28 days.

Results and discussion

Results showed that supplementing Fe-HMA as an iron source significantly increased the levels of triglycerides and glucose in portal venous serum, albumin in both serum and portal venous serum and decreased serum low-density lipoprotein level in weaned piglets. Additionally, Fe-HMA supplementation significantly reduced serum and liver malondialdehyde levels, while increasing catalase (CAT), glutathione peroxidase (GSH-Px), total superoxide dismutase, and manganese superoxide dismutase levels in serum, as well as GSH-Px and CAT levels in the liver. Moreover, Fe-HMA regulated the intestinal microbiota composition, notably increasing the relative abundance of Proteobacteria and decreasing microbes involved in aromatic_compound_degradation. In conclusion, dietary replacing inorganic iron with Fe-HMA improved metabolic parameters and antioxidant capacity, and regulated gut microbiota composition in weaned piglets.

Iron Administration Partially Ameliorates Cadmium-Induced Oxidative Damage in the Liver and Kidney of Rats

The protective effect of Fe against Cd-induced toxicity in the liver and kidney of rats during concurrent administration of both metals was investigated in this study. Fifty female rats (130-150 g) were distributed into five groups of 10 rats each (n = 10): Group I (control), received normal saline solution; Group II (1.2 mg CdCl2/kg b.w.); Group III (1.2 mg CdCl2 + 0.25 mg FeCl2/kg b.w.); Group IV (1.2 mg CdCl2 + 0.75 mg FeCl2/kg b.w.); and Group V (1.2 mg CdCl2 + 1.5 mg FeCl2/kg b.w.). Administration of both tested substances lasted for 47 days. Cd was injected intraperitoneally once a week, while Fe was administered to the Cd-exposed animals by oral gavage thrice weekly. The animals were killed at the end of the study, their blood was collected, and their liver and kidneys were harvested for biochemical and histological analysis. Following Cd administration, the kidney and liver showed a significant increase in Cd concentration, while Fe concentration in the kidney decreased. However, cotreatment with Fe decreased Cd concentration in the kidney and liver and increased Fe concentration in the kidney but not the liver, and the effect was more pronounced in the higher than lower doses. In the kidney, cotreatment with Fe especially at higher doses inhibited Cd-induced lipid peroxidation and plasma uric acid concentration. In the liver, lipid peroxidation which Cd did not alter was found to be elevated after cotreatment with the highest dose Fe. Inflammatory cell infiltrations of the central vein and renal tubular and glomeruli injury induced by Cd were not obviated by Fe cotreatment. It seems that both tissues respond differently to the concurrent administration of these metals and that Fe protected the kidney against oxidative injury-induced by Cd but not histopathological changes in both tissues.

HIF1α/miR-146α/TRAF6/NF-κB axis modulates hepatic iron overload-induced inflammation

Transfusional therapy is used to cure anemia but raises the risk of hepatic iron overload (IO), which triggers oxidative stress damage, inflammation, and failure even fibrosis. microRNAs play a vital role in developing hepatic diseases. This study presented the mechanism by which IO induce hepatic inflammation through microRNAs. In this study, microRNA expression profiling in the liver was observed after IO for 2 weeks, in which the target microRNA will be found. IO activating the miR-146α/TRAF6/NF-κB pathway was validated, and the molecular mechanism of the IO-induced decrease of miR-146α in the liver was studied in vivo and in vitro. The expression of TRAF6/NF-κB (p65)-dependent inflammatory factors increased, whereas the expression of miR-146α decreased during the IO-induced inflammatory response in the liver. The reduced expression of HNF4α caused by HIF1α and miR-34α may decrease the expression of miR-146α. Overexpression of miR-146α alleviated the hepatic inflammatory response caused by IO. Our findings indicate that miR-146α is a key factor in inducing hepatic IO inflammation, which will be another potential target to prevent IO-induced hepatic damage.

[Effects of microencapsulated and heme iron supplementation on the recovery of hemoglobin levels in iron-depleted rats]

Introduction

Introduction: one of the causes of nutritional anemia is that the amount of iron absorbed is insufficient to meet the body's needs. Objective: to determine the effects of microencapsulated and heminic iron supplementation to increase hemoglobin levels and body weight in iron-depleted rats. Methods: a randomized experimental study was designed. Four study groups were formed. Control group (GC), experimental group (GE1) (MC microencapsulated iron supplementation), experimental group 2 (GE2) (heminic iron supplementation) and experimental group 3 (GE3) (MC + heminic iron supplementation). A dry powdered diet containing all normal nutrients except iron was fed to the four groups for 15 days (three times a day). Weight, length and hemoglobin (Hb) were evaluated at pre- and post-test under similar conditions. Results: in Hb, no significant differences were observed in the CG (p = 0.225), despite a -9.6 % decrease in the post-test. GE1 significantly increased hemoglobin (14.3 %, Hb 2.1 g/dl) and body weight (21.6 %, 25.8 g) (p < 0.05) in the post-test. Similarly, GE2 significantly increased hemoglobin (14.5 %, Hb 2.1 g/dl) and body weight (44.5 %, 52.3 g) (p < 0.05). However, in GE3, despite significantly increasing weight (30.2 %, 35.2 g), the increase in hemoglobin levels was similar to what occurred in GE1 and GE2 groups (increasing by 14.5 % and Hb 2.2 g/dl). There were no significant differences in rat length between pre- and post-test in the four groups. Conclusion: these results suggest that heme iron together with quinoa and cañihua flour could be exploited as a new safe and efficient iron supplement compared to microencapsulated iron, given its higher iron bioavailability and its ability to increase body weight.

The Ideal Time for Iron Administration in Anemia Secondary to Blood Loss-An Experimental Animal Model

BACKGROUND

Anemia and iron deficiency are two of the main public health problems worldwide, associated with negative outcomes in surgical patients. This experimental study aimed to create a model of acute iron deficiency with anemia through blood loss and extensive surgery. Afterwards, intravenous iron was administered to correct the iron deficiency and to improve the hematological parameters in distinct moments regarding the surgical time. To assess the optimum time for therapeutic intervention, experimental subjects were compared, performing clinical, paraclinical, and histological examinations, as well.

METHODS

Male rats (n = 35), aged 11-13 months, were randomly designated into six groups. Anemia and iron deficiency were obtained through a 15% blood volume loss, followed by major surgical intervention (femur fracture and osteosynthesis using Kirschner wire). Therapeutic intervention was obtained with an intravenous ferric carboxymaltose infusion, as follows: group II: intraoperative (n = 7), group III: 48 h after surgery (n = 7), group IV: 48 h before surgery (n = 5), and group V: seven days before surgery (n = 6). Group I (n = 5) was left anemic, while group 0 (n = 5) was nonanemic without therapeutic intervention.

RESULTS AND DISCUSSION

In group I, serum iron lower than in group 0 (27.04 ± 6.92 μg/dL versus 60.5 ± 2.34 μg/dL), as well as hemoglobin (10.4 ± 0.54 g/dL versus 14.32 ± 2.01 g/dL) and ferritin values (22.52 ± 0.53 ng/mL versus 29.86 ± 3.97 ng/mL), validated the experimental model. Regarding wound healing after surgical trauma, we observed that neovascularization was more significant in group III, followed by group V, with fewer neutrophils, a well-represented and rich in lymphomonocytes inflammatory infiltrate associated with the biggest collagen fiber dimensions. The periosteal reaction and callus area presented thicker trabeculae in groups II and III compared to the anemic group.

CONCLUSIONS

This original experimental study assessed the effect of perioperative intravenous iron administration at a specific time by comparing the weight, hematological, and iron status-defining parameters, as well as histological characteristics of the included subjects. The present findings highlight that correcting the iron deficiency in emergency settings through intravenous iron administration intraoperatively or 48 h postoperatively could determine the improved bioumoral parameters, as well as a better evolution of the postoperative wound and bone healing compared to the anemic group or subjects that received therapeutic intervention 48 h before surgery.

Comparison of Oral and Parenteral Iron Administration on Iron Homeostasis, Oxidative and Immune Status in Anemic Neonatal Pigs

The present study was to evaluate the consequences of iron status across oral and parenteral iron administrations in prevention of iron deficiency anemia. A total of 24 one-day-old male neonatal piglets were allocated into three groups given non-iron supplementation (NON), intramuscular iron dextran injection (FeDex), and oral administration of ferrous glycine chelate (FeGly), respectively. At day 8, no significant differences in final body weight, average weight gain, and tissue coefficients were observed among three groups (P > 0.05). Both oral FeGly and FeDex injection significantly increased serum iron, ferritin, hemoglobin, and tissue iron deposition (P < 0.05). However, FeDex-injected supplementation resulted in rapidly rising hepcidin levels and hepatic iron deposition (P < 0.05). In addition, compared to parenteral iron supplementation, greater serum IgA level, SOD, and GSH-Px activities, lower expressions of IL-1β and TNF-α in the liver, and lower expressions of IL-6 and TNF-α in the spleen were found in oral iron piglets (P < 0.05). According to our results, oral administration of ferrous glycine chelate improved iron homeostasis, and oxidative and immune status in anemic neonatal pigs.

Trace Element Concentrations in Human Tissues of Death Cases Associated With Secondary Infection and MOF After Severe Trauma

Proper trace element level is crucial for the organs in maintaining normal physiological functions. Multiple organ failure (MOF) might be added to critically ill patients due to a lack of trace elements. Alterations of trace element levels in brain, heart, liver, and kidney after severe trauma, however, have been little studied so far. In this study, tissue samples of the frontal cortex of the brain, interventricular septum of the heart, right lobe of the liver, and upper pole of the kidney were obtained from forensic autopsies, of which 120 cases died during the 5th to 15th day of hospitalization, whereas the trauma death group and 43 cases immediately died due to severe craniocerebral trauma as the control group. Copper (Cu), iron (Fe), zinc (Zn), and selenium (Se) were quantified by inductively coupled plasma atomic emission spectrophotometry (ICP-AES). Cu, Fe, Zn, and Se concentrations in the brain, heart, liver, and kidney in the trauma group decreased dramatically (p<0.05) compared to the control group. The incidence of secondary infection and multiple organ failure (MOF) in the trauma death group were 78.33 and 29.17%, respectively. The concentrations of all elements exhibited a significant correlation with secondary infection and MOF (p<0.01). Our data suggest that low concentrations of Cu, Fe, Zn, and Se in pivotal organs may contribute to the incidence of secondary infection and MOF after severe trauma, which to some extent results in death.

Novel iron-containing phosphate binders and anemia treatment in CKD: oral iron intake revisited

Recent reports have shown that novel phosphate binders containing iron are not only efficacious for the treatment of hyperphosphatemia but also may reduce the need for erythropoiesis-stimulating agents and intravenous (IV) iron for anemia management in patients on maintenance hemodialysis (MHD). Possible healthcare cost savings, which have not been demonstrated in a long-term study, may be an additional advantage of using such multi-pronged treatment strategies for the control of both hyperphosphatemia and iron needs. It is currently assumed that oral iron supplementation is less efficient than the IV route in patients with chronic kidney disease (CKD). The unexpected efficacy of novel iron-containing phosphate binders, such as ferric citrate, in repleting insufficient iron stores and improving the anemia of CKD could change this view. Previous assumptions of self-controlled iron uptake by 'mucosal block' or hepcidin, or else by impaired intestinal iron absorption due to CKD-associated inflammation cannot be reconciled with recent observations of the effects of ferric citrate administration. Citrate in the intestinal lumen may partly contribute to the acceleration of iron absorption. Animal experiments and clinical studies have also shown that oral iron overload can cause excessive iron accumulation despite high hepcidin levels, which are not able to block iron absorption completely. However, like with IV iron agents, no long-term safety data exist with respect to the effects of iron-containing phosphate binders on 'hard' patient outcomes. Future randomized prospective studies in patients with CKD are necessary to establish the safety of oral iron-containing phosphate binders for the control of both hyperphosphatemia and renal anemia.

Effects of polyphenol-rich plant products from grape or hop as feed supplements on iron, zinc and copper status in piglets

Polyphenol-rich plant products as feed supplements have been shown to exert beneficial effects on feed efficiency in piglets. However, tannins as components of polyphenol-rich plant products are able to reduce the absorption of various trace elements. The present study investigated the effect of two polyphenol-rich dietary supplements, grape seed and grape marc meal extract (GME) and spent hops (SH), on iron (Fe), zinc (Zn) and copper (Cu) status in piglets supplied adequately with those trace elements. A trial with three groups of piglets which received a Control diet or the same diet supplemented with either 1% GME or 1% SH over a period of 4 weeks was performed. Concentrations of Fe, Zn and Cu in plasma, total iron binding capacity and saturation of transferrin in plasma did not differ between the three groups. Piglets fed the diet supplemented with SH showed no differences in the concentrations of Fe, Zn and Cu in the liver in comparison to the Control group. Piglets fed the diets supplemented with GME showed slightly lower concentrations of Zn and Cu in the liver than Control piglets (p < 0.05); however, concentrations of both elements remained in the physiological range. Overall, this study shows that the polyphenol-rich plant products GME and SH had marginal effect on the status of Fe, Zn and Cu in piglets.