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Song L, Zhu L, Qiao S, Song L, Zhang M, Xue T, Lv B, Liu H, Zhang X. Preparation, characterization, and bioavailability evaluation of antioxidant phosvitin peptide-ferrous complex. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2024; 104:3090-3099. [PMID: 38063464 DOI: 10.1002/jsfa.13200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 10/22/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Iron deficiency anemia (IDA) is one of the commonest global nutritional deficiency diseases, and the low bioavailability of iron is a key contributing factor. The peptide-iron complex could be used as a novel iron supplement to improve iron bioavailability. RESULTS In this study, antioxidant low molecular weight (<3 kDa) phosvitin peptide (named PP-4) was separated to prepare a phosvitin peptide-ferrous complex (named PP-4-Fe); then the structural conformation of PP-4-Fe was characterized and its bioavailability by in vitro digestion was evaluated. The results showed that PP-4 had good ferrous-binding activity with 96.14 ± 2.86 μg Fe2+ mg-1 , and had a strong antioxidant effect with 995.61 ± 79.75 μmol TE mg-1 in 2,2'-azinobis'3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and 62.3 ± 3.95 μmol FeSO4 mg-1 in ferric ion reducing antioxidant power (FRAP). After ferrous binding, the FRAP activity of PP-4-Fe, enhanced by 1.8 times, formed a more ordered structure with an increase in α-helix and decrease in γ-random coil. The ferrous binding sites of PP-4 involved were the amino, carboxyl, imidazole, and phosphate groups. The PP-4-Fe complex displayed excellent gastrointestinal stability and antioxidant effects during digestion. The iron dialysis percentage of PP-4-Fe was 74.59% ± 0.68%, and increased to 81.10% ± 0.89% with the addition of 0.25 times vitamin C (VC). This indicated that PP-4-Fe displayed excellent bioavailability and VC in sufficient quantities had a synergistic effect on improving bioavailability. CONCLUSIONS This study demonstrated that antioxidant phosvitin peptide was an efficient delivery system to protect ferrous ions and suggested that the phosvitin peptide-ferrous complex has strong potential as a ferrous supplement. © 2023 Society of Chemical Industry.
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Affiliation(s)
- Lushan Song
- State Key Laboratory of Food Nutrition and Safety, Tianjin Key Laboratory of Food Quality and Health, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Linxian Zhu
- State Key Laboratory of Food Nutrition and Safety, Tianjin Key Laboratory of Food Quality and Health, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Saifeng Qiao
- State Key Laboratory of Food Nutrition and Safety, Tianjin Key Laboratory of Food Quality and Health, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Li Song
- State Key Laboratory of Food Nutrition and Safety, Tianjin Key Laboratory of Food Quality and Health, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Mingran Zhang
- State Key Laboratory of Food Nutrition and Safety, Tianjin Key Laboratory of Food Quality and Health, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Tianrui Xue
- State Key Laboratory of Food Nutrition and Safety, Tianjin Key Laboratory of Food Quality and Health, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Binfei Lv
- State Key Laboratory of Food Nutrition and Safety, Tianjin Key Laboratory of Food Quality and Health, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Huiping Liu
- State Key Laboratory of Food Nutrition and Safety, Tianjin Key Laboratory of Food Quality and Health, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Xiaowei Zhang
- State Key Laboratory of Food Nutrition and Safety, Tianjin Key Laboratory of Food Quality and Health, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
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Świątek M, Antosik A, Kochanowska D, Jeżowski P, Smarzyński K, Tomczak A, Kowalczewski PŁ. The potential for the use of leghemoglobin and plant ferritin as sources of iron. Open Life Sci 2023; 18:20220805. [PMID: 38152583 PMCID: PMC10751998 DOI: 10.1515/biol-2022-0805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 12/29/2023] Open
Abstract
Iron is an essential component for the body, but it is also a major cause for the development of many diseases such as cancer, cardiovascular diseases, and autoimmune diseases. It has been suggested that a diet rich in meat products, especially red meat and highly processed products, constitute a nutritional model that increases the risk of developing. In this context, it is indicated that people on an elimination diet (vegetarians and vegans) may be at risk of deficiencies in iron, because this micronutrient is found mainly in foods of animal origin and has lower bioavailability in plant foods. This article reviews the knowledge on the use of leghemoglobin and plant ferritin as sources of iron and discusses their potential for use in vegetarian and vegan diets.
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Affiliation(s)
- Michał Świątek
- Ekosystem-Nature’s Heritage Association, Institute of Microbial Technologies, Al. NSZZ Solidarność 9, 62-700Turek, Poland
| | - Adrianna Antosik
- Ekosystem-Nature’s Heritage Association, Institute of Microbial Technologies, Al. NSZZ Solidarność 9, 62-700Turek, Poland
| | - Dominika Kochanowska
- Ekosystem-Nature’s Heritage Association, Institute of Microbial Technologies, Al. NSZZ Solidarność 9, 62-700Turek, Poland
| | - Paweł Jeżowski
- Institute of Chemistry and Technical Electrochemistry, Poznan University of Technology, 4 Berdychowo St., 60-965Poznań, Poland
- InnPlantFood Research Group, Poznań University of Life Sciences, 31 Wojska Polskiego St., 60-624Poznań, Poland
| | - Krzysztof Smarzyński
- InnPlantFood Research Group, Poznań University of Life Sciences, 31 Wojska Polskiego St., 60-624Poznań, Poland
| | - Aneta Tomczak
- Department of Biochemistry and Food Analysis, Poznań University of Life Sciences, 48 Mazowiecka St., 60-623Poznań, Poland
| | - Przemysław Łukasz Kowalczewski
- InnPlantFood Research Group, Poznań University of Life Sciences, 31 Wojska Polskiego St., 60-624Poznań, Poland
- Department of Food Technology of Plant Origin, Poznań University of Life Sciences, 31 Wojska Polskiego St., 60-624Poznań, Poland
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Fischer JAJ, Cherian AM, Bone JN, Karakochuk CD. The effects of oral ferrous bisglycinate supplementation on hemoglobin and ferritin concentrations in adults and children: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev 2023; 81:904-920. [PMID: 36728680 PMCID: PMC10331582 DOI: 10.1093/nutrit/nuac106] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
CONTEXT Iron deficiency and anemia have serious consequences, especially for children and pregnant women. Iron salts are commonly provided as oral supplements to prevent and treat iron deficiency, despite poor bioavailability and frequently reported adverse side effects. Ferrous bisglycinate is a novel amino acid iron chelate that is thought to be more bioavailable and associated with fewer gastrointestinal (GI) adverse events as compared with iron salts. OBJECTIVE A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to evaluate the effects of ferrous bisglycinate supplementation compared with other iron supplements on hemoglobin and ferritin concentrations and GI adverse events. DATA SOURCES A systematic search of electronic databases and grey literature was performed up to July 17, 2020, yielding 17 RCTs that reported hemoglobin or ferritin concentrations following at least 4 weeks' supplementation of ferrous bisglycinate compared with other iron supplements in any dose or frequency. DATA EXTRACTION Random-effects meta-analyses were conducted among trials of pregnant women (n = 9) and children (n = 4); pooled estimates were expressed as standardized mean differences (SMDs). Incidence rate ratios (IRRs) were estimated for GI adverse events, using Poisson generalized linear mixed-effects models. The remaining trials in other populations (n = 4; men and nonpregnant women) were qualitatively evaluated. DATA ANALYSIS Compared with other iron supplements, supplementation with ferrous bisglycinate for 4-20 weeks resulted in higher hemoglobin concentrations in pregnant women (SMD, 0.54 g/dL; 95% confidence interval [CI], 0.15-0.94; P < 0.01) and fewer reported GI adverse events (IRR, 0.36; 95%CI, 0.17-0.76; P < 0.01). We observed a non-significant trend for higher ferritin concentrations in pregnant women supplemented with ferrous bisglycinate. No significant differences in hemoglobin or ferritin concentrations were detected among children. CONCLUSION Ferrous bisglycinate shows some benefit over other iron supplements in increasing hemoglobin concentration and reducing GI adverse events among pregnant women. More trials are needed to assess the efficacy of ferrous bisglycinate against other iron supplements in other populations. PROSPERO REGISTRATION NO CRD42020196984.
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Affiliation(s)
- Jordie A J Fischer
- Department of Food, Nutrition, and Health, The University of British Columbia, Vancouver, British Columbia, Canada. Healthy Starts, BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Arlin M Cherian
- Department of Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeffrey N Bone
- BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Crystal D Karakochuk
- Department of Food, Nutrition, and Health, The University of British Columbia, Vancouver, British Columbia, Canada. Healthy Starts, BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
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Fan C, Ge X, Hao J, Wu T, Liu R, Sui W, Geng J, Zhang M. Identification of high iron–chelating peptides with unusual antioxidant effect from sea cucumbers and the possible binding mode. Food Chem 2023; 399:133912. [DOI: 10.1016/j.foodchem.2022.133912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/11/2022] [Accepted: 08/07/2022] [Indexed: 11/30/2022]
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Preparation, Characterization and Iron Absorption by Caco-2 Cells of the Casein Peptides-Iron Chelate. Int J Pept Res Ther 2022. [DOI: 10.1007/s10989-022-10423-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hu S, Lin S, He X, Sun N. Iron delivery systems for controlled release of iron and enhancement of iron absorption and bioavailability. Crit Rev Food Sci Nutr 2022; 63:10197-10216. [PMID: 35588258 DOI: 10.1080/10408398.2022.2076652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Iron deficiency is a global nutritional problem, and adding iron salts directly to food will have certain side effects on the human body. Therefore, there is growing interest in food-grade iron delivery systems. This review provides an overview of iron delivery systems, with emphasis on the controlled release of iron during gastrointestinal digestion, as well as the enhancement of iron absorption and bioavailability. Iron-bearing proteins are easily degraded by digestive enzymes and absorbed through receptor-mediated endocytosis. Instead, protein aggregates are slowly degraded in the stomach, which delays iron release and serves as a potential iron supplement. Amino acids, peptides and polysaccharides can bind iron through iron binding sites, but the formed compounds are prone to dissociation in the stomach. Moreover, peptides and polysaccharides can deliver iron by mediating the formation of ferric oxyhydroxide which is absorbed through endocytosis or bivalent transporter 1. In addition, liposomes are unstable during gastric digestion and iron is released in large quantities. Complexes formed by polysaccharides and proteins, and microcapsules formed by polysaccharides can delay the release of iron in the gastric environment and prolong iron release in the intestinal environment. This review is conducive to the development of iron functional ingredients and dietary supplements.
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Affiliation(s)
- Shengjie Hu
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian, P. R. China
| | - Songyi Lin
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian, P. R. China
- Collaborative Innovation Center of Seafood Deep Processing, Dalian Polytechnic University, Dalian, P. R. China
| | - Xueqing He
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian, P. R. China
| | - Na Sun
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian, P. R. China
- Collaborative Innovation Center of Seafood Deep Processing, Dalian Polytechnic University, Dalian, P. R. China
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7
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Song Y, Wang X, Bu X, Huang Q, Qiao F, Chen X, Shi Q, Qin J, Chen L. A Comparation Between Different Iron Sources on Growth Performance, Iron Utilization, Antioxidant Capacity and Non-specific Immunity in Eriocheir sinensis. Anim Feed Sci Technol 2022. [DOI: 10.1016/j.anifeedsci.2022.115300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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8
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Gamble LA, Davis JL. Surveillance and Surgical Considerations in Hereditary Diffuse Gastric Cancer. Gastrointest Endosc Clin N Am 2022; 32:163-175. [PMID: 34798984 DOI: 10.1016/j.giec.2021.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Inactivating germline variants in the CDH1 tumor suppressor gene cause the hereditary diffuse gastric cancer syndrome. Total gastrectomy is recommended for prevention, although it is associated with adverse outcomes and chronic health risks. Gastric cancer surveillance is an alternative to surgery; however, upper gastrointestinal endoscopy is limited by poor sensitivity. Cancer surveillance requires accurate detection of early carcinoma and patient-specific disease penetrance estimates. Current clinical care should incorporate up-to-date information on variable disease penetrance, which does not seem to correlate with CDH1 genotype. Affected patients and families warrant a balanced presentation of options for cancer surveillance and prophylaxis.
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Affiliation(s)
- Lauren A Gamble
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Drive, Room 4-3742, Bethesda, MD 20892, USA
| | - Jeremy L Davis
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Drive, Room 4-3742, Bethesda, MD 20892, USA.
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Hu S, Lin S, Wang D, Zhang S, Sun N. Antarctic krill-derived peptides with consecutive Glu residues enhanced iron binding, solubility, and absorption. Food Funct 2021; 12:8615-8625. [PMID: 34346465 DOI: 10.1039/d1fo01405f] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Three peptides containing three glutamic acid (Glu) residues at different positions derived from Antarctic krill were obtained to investigate their iron-binding properties, digestive stability, and effectiveness on enhancing iron solubility and absorption. Results indicated that Fe2+ bound to the carbonyl, carboxyl, or hydroxyl groups of DELEDSLER, EEEFDATR, and DTDSEEEIR at stoichiometric ratios of 0.453, 0.466, and 0.490, respectively. DTDSEEEIR with three consecutive Glu in the middle of the sequence possessed higher iron-binding ability and iron release potential than EEEFDATR with three consecutive Glu in the N-terminal, and DELEDSLER with three discontinuous Glu showed the lowest values. Although EEEFDATR showed remarkably lower digestion stability than DTDSEEEIR, the effect of EEEFDATR-iron on iron solubility and absorption was comparable to that of DTDSEEEIR-iron, but better than that of DELEDSLER-iron and FeSO4. Thus, peptides with consecutive Glu have the potential as an effective iron carrier to improve iron absorption.
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Affiliation(s)
- Shengjie Hu
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, P. R. China.
| | - Songyi Lin
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, P. R. China. and Collaborative Innovation Center of Seafood Deep Processing, Dalian Polytechnic University, Dalian 116034, P. R. China
| | - Di Wang
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, P. R. China.
| | - Shuyue Zhang
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, P. R. China.
| | - Na Sun
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, P. R. China. and Collaborative Innovation Center of Seafood Deep Processing, Dalian Polytechnic University, Dalian 116034, P. R. China
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Man Y, Xu T, Adhikari B, Zhou C, Wang Y, Wang B. Iron supplementation and iron-fortified foods: a review. Crit Rev Food Sci Nutr 2021; 62:4504-4525. [PMID: 33506686 DOI: 10.1080/10408398.2021.1876623] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
About one-third of the world population is suffering from iron deficiency. Delivery of iron through diet is a practical, economical, and sustainable approach. Clinical studies have shown that the consumption of iron-fortified foods is one of the most effective methods for the prevention of iron deficiency. However, supplementing iron through diet can cause undesirable side-effects. Thus, it is essential to develop new iron-rich ingredients, iron-fortified products with high bioavailability, better stability, and lower cost. It is also essential to develop newer processing technologies for more effective fortification. This review compared the iron supplementation strategies used to treat the highly iron-deficient population and the general public. We also reviewed the efficacy of functional (iron-rich) ingredients that can be incorporated into food materials to produce iron-fortified foods. The most commonly available foods, such as cereals, bakery products, dairy products, beverages, and condiments are still the best vehicles for iron fortification and delivery.Scope of reviewThe manuscript aims at providing a comprehensive review of the latest publications that cover three aspects: administration routes for iron supplementation, iron-rich ingredients used for iron supplementation, and iron-fortified foods.
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Affiliation(s)
- Yaxing Man
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang, PR China
| | - Tiantian Xu
- Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, South China Agricultural University, Guangzhou, PR China
| | - Benu Adhikari
- School of Science, RMIT University, Melbourne, Australia
| | - Cunshan Zhou
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang, PR China
| | - Yuchuan Wang
- School of Food Engineering, Jiangnan University, Wuxi, PR China
| | - Bo Wang
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang, PR China
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11
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Morales R, Martinez MJ, Pilosof AMR. Iron-caseinglycomacropeptide complexes: Characterization and application in beverages. Food Res Int 2020; 138:109772. [PMID: 33292951 DOI: 10.1016/j.foodres.2020.109772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/20/2020] [Accepted: 09/30/2020] [Indexed: 11/28/2022]
Abstract
Complexing iron with organic compounds has been considered an alternative strategy to mitigate the problems associated with the level of bioavailable iron and the acceptability of products supplemented with this mineral. CMP contains specific amino acids associated with iron binding. The present study aims to optimize the conditions of Fe/CMP complex formation and understand the molecular basis of interactions between CMP and iron ions. Results showed that CMP can bind ferrous iron in a 1:1.5 M ratio, forming a stable peptide-iron complex, where CMP assembles in a tetrameric form. FTIR spectra indicated that iron binding altered the secondary structures of CMP. The iron-binding sites of CMP corresponded primarily to acid residues of Glu, Asp and sialic acid. Moreover, Fe/CMP complex remained stable in a wide pH range (2.0-6.5), suggesting the adequacy to be efficiently added in food or beverages and to keeping complexed in the digestion environment. Finally, Fe/CMP complex was added to a commercial beverage (2 mg of Fe per serving of beverage) and no changes were observed in their colour during storage. A model to explain the binding between CMP and iron is proposed. These results suggest a potential application of this peptide for iron fortification.
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Affiliation(s)
- Rocío Morales
- Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de Industrias, Buenos Aires, Argentina; CONICET - Universidad de Buenos Aires, Instituto de Tecnología de Alimentos y Procesos Químicos (ITAPROQ), Buenos Aires, Argentina.
| | - María Julia Martinez
- Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de Industrias, Buenos Aires, Argentina; CONICET - Universidad de Buenos Aires, Instituto de Tecnología de Alimentos y Procesos Químicos (ITAPROQ), Buenos Aires, Argentina.
| | - Ana María Renata Pilosof
- Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de Industrias, Buenos Aires, Argentina; CONICET - Universidad de Buenos Aires, Instituto de Tecnología de Alimentos y Procesos Químicos (ITAPROQ), Buenos Aires, Argentina.
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12
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Caetano-Silva ME, Netto FM, Bertoldo-Pacheco MT, Alegría A, Cilla A. Peptide-metal complexes: obtention and role in increasing bioavailability and decreasing the pro-oxidant effect of minerals. Crit Rev Food Sci Nutr 2020; 61:1470-1489. [PMID: 32370550 DOI: 10.1080/10408398.2020.1761770] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Bioactive peptides derived from food protein sources have been widely studied in the last years, and scientific researchers have been proving their role in human health, beyond their nutritional value. Several bioactivities have been attributed to these peptides, such as immunomodulatory, antimicrobial, antioxidant, antihypertensive, and opioid. Among them, metal-binding capacity has gained prominence. Mineral chelating peptides have shown potential to be applied in food products so as to decrease mineral deficiencies since peptide-metal complexes could enhance their bioavailability. Furthermore, many studies have been investigating their potential to decrease the Fe pro-oxidant effect by forming a stable structure with the metal and avoiding its interaction with other food constituents. These complexes can be formed during gastrointestinal digestion or can be synthesized prior to intake, with the aim to protect the mineral through the gastrointestinal tract. This review addresses: (i) the amino acid residues for metal-binding peptides and their main protein sources, (ii) peptide-metal complexation prior to or during gastrointestinal digestion, (iii) the function of metal (especially Fe, Ca, and Zn)-binding peptides on the metal bioavailability and (iv) their reactivity and possible pro-oxidant and side effects.
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Affiliation(s)
| | - Flavia Maria Netto
- Faculty of Food Engineering, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | | | - Amparo Alegría
- Nutrition and Food Science Area, Faculty of Pharmacy, University of Valencia, Valencia, Spain
| | - Antonio Cilla
- Nutrition and Food Science Area, Faculty of Pharmacy, University of Valencia, Valencia, Spain
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Micronutrients Dietary Supplementation Advices for Celiac Patients on Long-Term Gluten-Free Diet with Good Compliance: A Review. ACTA ACUST UNITED AC 2019; 55:medicina55070337. [PMID: 31277328 PMCID: PMC6681258 DOI: 10.3390/medicina55070337] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 12/12/2022]
Abstract
Background and objective: Often micronutrient deficiencies cannot be detected when patient is already following a long-term gluten-free diet with good compliance (LTGFDWGC). The aim of this narrative review is to evaluate the most recent literature that considers blood micronutrient deficiencies in LTGFDWGC subjects, in order to prepare dietary supplementation advice (DSA). Materials and methods: A research strategy was planned on PubMed by defining the following keywords: celiac disease, vitamin B12, iron, folic acid, and vitamin D. Results: This review included 73 studies. The few studies on micronutrient circulating levels in long-term gluten-free diet (LTGFD) patients over 2 years with good compliance demonstrated that deficiency was detected in up to: 30% of subjects for vitamin B12 (DSA: 1000 mcg/day until level is normal, then 500 mcg), 40% for iron (325 mg/day), 20% for folic acid (1 mg/day for 3 months, followed by 400–800 mcg/day), 25% for vitamin D (1000 UI/day or more-based serum level or 50,000 UI/week if level is <20 ng/mL), 40% for zinc (25–40 mg/day), 3.6% of children for calcium (1000–1500 mg/day), 20% for magnesium (200–300 mg/day); no data is available in adults for magnesium. Conclusions: If integration with diet is not enough, starting with supplements may be the correct way, after evaluating the initial blood level to determine the right dosage of supplementation.
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Wan D, Wu Q, Ni H, Liu G, Ruan Z, Yin Y. Treatments for Iron Deficiency (ID): Prospective Organic Iron Fortification. Curr Pharm Des 2019; 25:325-332. [DOI: 10.2174/1381612825666190319111437] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 03/13/2019] [Indexed: 12/27/2022]
Abstract
Iron deficiency, one of the most common nutritional deficient disorders, frequently affects infants,
adolescents and pregnant women and impairs growth, development and immune responses. Iron deficiency may
also be secondary to gastrointestinal conditions such as gastrectomy and inflammatory bowel disease, as well as
cancer and chronic uremia. Iron supplementation is the most commonly selected treatment option for iron deficiency.
This review summarizes the iron compounds currently recommended for the iron fortification of foods
and for clinical use. Additionally, this review discusses and compares the important aspects of high-quality iron
compounds/products and classes of compounds that enhance iron bioavailability. The development of efficient
iron fortification methods remains the most cost-effective and long-term approach to the treatment of iron deficiency
or related anemia. To date, no orally administered options for iron fortification can sufficiently replace the
parenteral administration of iron supplements, which includes the intramuscular injection of iron-dextran to neonatal
piglets and intravenous injection of iron supplements to patients with gastrointestinal disorders. Iron
bioavailability may be enhanced by encouraging customers to ingest iron-enriched foods together with dietary
sources of vitamin C, folic acid and/or oligosaccharides.
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Affiliation(s)
- Dan Wan
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Qinghua Wu
- College of Life Science, Yangtze University, Jingzhou, China
| | - Hengjia Ni
- Academician Workstation of Hunan Baodong Farming Co. Ltd., Hunan 422001, China
| | - Gang Liu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Zheng Ruan
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Yulong Yin
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
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Santamaría MM, Villafranca JJA, Abilés J, López AF, Rodas LV, Goitia BT, Navarro PU. Systematic review of drug bioavailability following gastrointestinal surgery. Eur J Clin Pharmacol 2018; 74:1531-1545. [PMID: 30136101 DOI: 10.1007/s00228-018-2539-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 08/07/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE Inter- and intraindividual pharmacokinetics variability in humans affects the way in which drugs act on the body. Gastrointestinal surgery has an impact on this variability and significantly alters the kinetics of drugs in post-surgical patients. The way in which pharmacokinetic profiles are modified depends on the type of operative procedure performed. The extent to which the absorption of different groups of drugs is affected varies according to the site and length of intestinal resections. METHODS A literature search was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Three databases were searched: MEDLINE, Embase, and the Cochrane Library. For each drug, potential changes in absorption were described, including recommendations extracted from the results of the studies and collected according to authors' criteria as practical conclusions, and grades of recommendation were determined by levels of evidence using the Oxford Centre for Evidence-Based Medicine scale. RESULTS Sixty-eight articles were collected during the selection process after the bibliographic search. The main outcomes for 60 drugs from the various studies were classified according to each type of surgery. CONCLUSIONS Modifications in the digestive tract secondary to gastrointestinal surgery may compromise the bioavailability of drugs. Decreased absorption surface, gastric emptying speed, and gastric pH alteration are factors to be taken into account in the management of pharmacological treatment after surgery. Evidence supported by data in clinical practice is scarce, but after studying the pharmacokinetic profile of some molecules, it is possible to offer recommendations for its adaptation to the patient's clinical situation.
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Affiliation(s)
- Manuela Moreno Santamaría
- Pharmacy and Nutrition Department, Costa del Sol Hospital, A-7, Km 187, 29603, Marbella, Málaga, Spain.
| | | | - Jimena Abilés
- Pharmacy and Nutrition Department, Costa del Sol Hospital, A-7, Km 187, 29603, Marbella, Málaga, Spain
| | - Alberto Fernández López
- Surgery Department, Quirónsalud Hospital, Edificio Arttysur, Avda. de los Empresarios, s/n, 11379, Palmones, Cádiz, Spain
| | - Lucia Visiedo Rodas
- Pharmacy and Nutrition Department, Costa del Sol Hospital, A-7, Km 187, 29603, Marbella, Málaga, Spain
| | - Begoña Tortajada Goitia
- Pharmacy and Nutrition Department, Costa del Sol Hospital, A-7, Km 187, 29603, Marbella, Málaga, Spain
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16
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He H, An F, Teng H, Huang Q, Song H. Preparation and characterisation of a novel agar oligosaccharide-iron (III) complex. Int J Food Sci Technol 2018. [DOI: 10.1111/ijfs.13921] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Hong He
- College of Food Science; Fujian Agriculture and Forestry University; Fuzhou 350002 China
| | - Fengping An
- College of Food Science; Fujian Agriculture and Forestry University; Fuzhou 350002 China
| | - Hui Teng
- College of Food Science; Fujian Agriculture and Forestry University; Fuzhou 350002 China
| | - Qun Huang
- College of Food Science; Fujian Agriculture and Forestry University; Fuzhou 350002 China
- Fujian Provincial Key Laboratory of Quality Science and Processing Technology in Special Starch; Fuzhou 350002 China
| | - Hongbo Song
- College of Food Science; Fujian Agriculture and Forestry University; Fuzhou 350002 China
- Fujian Provincial Key Laboratory of Quality Science and Processing Technology in Special Starch; Fuzhou 350002 China
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17
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Garcés V, Rodríguez-Nogales A, González A, Gálvez N, Rodríguez-Cabezas ME, García-Martin ML, Gutiérrez L, Rondón D, Olivares M, Gálvez J, Dominguez-Vera JM. Bacteria-Carried Iron Oxide Nanoparticles for Treatment of Anemia. Bioconjug Chem 2018; 29:1785-1791. [PMID: 29718659 DOI: 10.1021/acs.bioconjchem.8b00245] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The efficiency of maghemite nanoparticles for the treatment of anemia was sensibly higher when nanoparticles were incorporated onto the probiotic bacterium Lactobacillus fermentum (MNP-bacteria) than when administrated as uncoated nanoparticles (MNP). Plasma iron and hemoglobin, intestine expression of divalent metal transporter 1 (DMT1) and duodenal Cytochrome b (DcytB), as well as hepatic expression of the hormone hepcidin were fully restored to healthy levels after administration of MNP-bacteria but not of MNP. A magnetic study on biodistribution and biodegradation showed accumulation of maghemite nanoparticles in intestine lumen when MNP-bacteria were administrated. In contrast, MNP barely reached intestine. In vivo MRI studies suggested the internalization of MNP-bacteria into enterocytes, which did not occur with MNP. Transmission electronic microscopy confirmed this internalization. The collective analysis of results point out that L. fermentum is an excellent carrier to overcome the stomach medium and drive maghemite nanoparticles to intestine, where iron absorption occurs. Due the probiotic ability to adhere to the gut wall, MNP-bacteria internalize into the enterocyte, where maghemite nanoparticles are delivered, providing an adequate iron level into enterocyte. This paper advances a new route for effective iron absorption in the treatment of anemia.
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Affiliation(s)
- Víctor Garcés
- Department of Inorganic Chemistry and Biotechnology Institute , Universidad de Granada , 18071 Granada , Spain
| | - Alba Rodríguez-Nogales
- Department of Pharmacology, CIBER-EHD, ibs. Granada, CIBM , Universidad de Granada , 18100 Granada , Spain
| | - Ana González
- Department of Inorganic Chemistry and Biotechnology Institute , Universidad de Granada , 18071 Granada , Spain
| | - Natividad Gálvez
- Department of Inorganic Chemistry and Biotechnology Institute , Universidad de Granada , 18071 Granada , Spain
| | - M Elena Rodríguez-Cabezas
- Department of Pharmacology, CIBER-EHD, ibs. Granada, CIBM , Universidad de Granada , 18100 Granada , Spain
| | - María L García-Martin
- BIONAND, Andalusian Centre for Nanomedicine and Biotechnology, Junta de Andalucía , Universidad de Málaga , 29590 Málaga , Spain
| | - Lucia Gutiérrez
- Departament of Analytical Chemistry, Institute of Nanoscience of Aragon , Universidad de Zaragoza y CIBER-BBN , 50018 Zaragoza , Spain
| | - Deyanira Rondón
- Biosearch S. A. Camino de Purchil, 66 , 18004 Granada , Spain
| | - Mónica Olivares
- Biosearch S. A. Camino de Purchil, 66 , 18004 Granada , Spain
| | - Julio Gálvez
- Department of Pharmacology, CIBER-EHD, ibs. Granada, CIBM , Universidad de Granada , 18100 Granada , Spain
| | - Jose M Dominguez-Vera
- Department of Inorganic Chemistry and Biotechnology Institute , Universidad de Granada , 18071 Granada , Spain
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Caetano-Silva ME, Cilla A, Bertoldo-Pacheco MT, Netto FM, Alegría A. Evaluation of in vitro iron bioavailability in free form and as whey peptide-iron complexes. J Food Compost Anal 2018. [DOI: 10.1016/j.jfca.2017.03.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Caetano-Silva ME, Barros Mariutti LR, Bragagnolo N, Bertoldo-Pacheco MT, Netto FM. Whey Peptide-Iron Complexes Increase the Oxidative Stability of Oil-in-Water Emulsions in Comparison to Iron Salts. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2018; 66:1981-1989. [PMID: 29397714 DOI: 10.1021/acs.jafc.7b04873] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Food fortification with iron may favor lipid oxidation in both food matrices and the human body. This study aimed at evaluating the effect of peptide-iron complexation on lipid oxidation catalyzed by iron, using oil-in-water (O/W) emulsions as a model system. The extent of lipid oxidation of emulsions containing iron salts (FeSO4 or FeCl2) or iron complexes (peptide-iron complexes or ferrous bisglycinate) was evaluated during 7 days, measured as primary (peroxide value) and secondary products (TBARS and volatile compounds). Both salts catalyzed lipid oxidation, leading to peroxide values 2.6- to 4.6-fold higher than the values found for the peptide-iron complexes. The addition of the peptide-iron complexes resulted in the formation of lower amounts of secondary volatiles of lipid oxidation (up to 78-fold) than those of iron salts, possibly due to the antioxidant activity of the peptides and their capacity to keep iron apart from the lipid phase, since the iron atom is coordinated and takes part in a stable structure. The peptide-iron complexes showed potential to reduce the undesirable sensory changes in food products and to decrease the side effects related to free iron and the lipid damage of cell membranes in the organism, due to the lower reactivity of iron in the complexed form.
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Affiliation(s)
- Maria Elisa Caetano-Silva
- Department of Food and Nutrition, Faculty of Food Engineering, University of Campinas, UNICAMP , 13083-862 Campinas, SP, Brazil
| | - Lilian Regina Barros Mariutti
- Department of Food and Nutrition, Faculty of Food Engineering, University of Campinas, UNICAMP , 13083-862 Campinas, SP, Brazil
| | - Neura Bragagnolo
- Department of Food Science, Faculty of Food Engineering, University of Campinas, UNICAMP , 13083-862 Campinas, SP, Brazil
| | | | - Flavia Maria Netto
- Department of Food and Nutrition, Faculty of Food Engineering, University of Campinas, UNICAMP , 13083-862 Campinas, SP, Brazil
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Abstract
Postgastrectomy syndromes result from altered form and function of the stomach. Gastrectomy disrupts reservoir capacity, mechanical digestion and gastric emptying. Early recognition of symptoms with prompt evaluation and treatment is essential. Many syndromes resolve with minimal intervention or dietary modifications. Re-operation is not common but often warranted for afferent and efferent loop syndromes and bile reflux gastritis. Preoperative nutritional assessment and treatment of common vitamin and mineral deficiencies after gastrectomy can reduce the incidence of chronic complications. An integrated team approach to risk assessment, patient education, and postoperative management is critical to optimal care of patients with gastric cancer.
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21
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Yuan L, Ji X, Chen J, Xie M, Geng L, Gao R. Enhanced oral bioavailability and tissue distribution of ferric citrate through liposomal encapsulation. CYTA - JOURNAL OF FOOD 2016. [DOI: 10.1080/19476337.2016.1221858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Clevenger B, Gurusamy K, Klein AA, Murphy GJ, Anker SD, Richards T. Systematic review and meta-analysis of iron therapy in anaemic adults without chronic kidney disease: updated and abridged Cochrane review. Eur J Heart Fail 2016; 18:774-85. [PMID: 27121474 DOI: 10.1002/ejhf.514] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 11/29/2015] [Accepted: 01/03/2016] [Indexed: 12/16/2022] Open
Abstract
AIMS Anaemia is increasingly recognized as having an independent impact upon patient outcomes in cardiac disease. The role of novel iron therapies to treat anaemia is increasing. This systematic review and meta-analysis assesses the efficacy and safety of iron therapies for the treatment of adults with anaemia. METHODS AND RESULTS Electronic databases and search engines were searched as per Cochrane methodology. Randomized controlled trials (RCTs) of iron vs. inactive control or placebo, as well as alternative formulations, doses, and routes in anaemic adults without chronic kidney disease or in the peri-partum period were eligible. The primary outcome of interest was mortality at 1 year. Secondary outcomes were blood transfusion, haemoglobin levels, quality of life, serious adverse events, and length of hospital stay. A total of 64 RCTs (including five studies of heart failure patients) comprising 9004 participants were included. None of the studies was at a low risk of bias. There were no statistically significant differences in mortality between iron and inactive control. Both oral and parenteral iron significantly reduced the proportion of patients requiring blood transfusion compared with inactive control [risk ratio (RR) 0.66, 95% confidence interval (CI) 0.48-0.90; and RR 0.84, 95% CI 0.73-0.97, respectively]. Haemoglobin was increased more by both oral and parenteral iron compared with inactive control [mean difference (MD) 0.91 g/dL, 95% CI 0.48 to 1.35; and MD 1.04, 95% CI 0.52 to 1.57, respectively], and parenteral iron demonstrated a greater increase when compared with oral iron (MD 0.53 g/dL, 95% CI 0.31-0.75). In all comparisons, there were no differences in the results comparing patients with and without heart failure. CONCLUSION Both oral and parenteral iron are shown to decrease the proportion of people who require blood transfusion and increase haemoglobin levels, without any benefit on mortality. Further trials at a low risk of bias, powered to measure clinically significant endpoints, are still required.
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Affiliation(s)
- Ben Clevenger
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Kurinchi Gurusamy
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Andrew A Klein
- Department of Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, UK
| | - Gavin J Murphy
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, University of Leicester, and Glenfield General Hospital, Leicester, UK
| | - Stefan D Anker
- Department of Innovative Clinical Trials, University Medical Centre Göttingen (UMG), Göttingen, Germany
| | - Toby Richards
- Division of Surgery and Interventional Science, University College London, London, UK
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23
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Tay HS, Soiza RL. Systematic review and meta-analysis: what is the evidence for oral iron supplementation in treating anaemia in elderly people? Drugs Aging 2016; 32:149-58. [PMID: 25644019 DOI: 10.1007/s40266-015-0241-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Oral iron supplementation is used widely in older people despite observational studies suggesting it is ineffective. OBJECTIVE The aim of this systematic review was to determine if oral iron therapy is effective in elderly people with iron deficiency anaemia. DATA SOURCES MEDLINE, EMBASE and The Cochrane Library databases were searched from inception to 23 January 2014. STUDY SELECTION Randomised controlled trials comparing oral iron with no iron supplementation or placebo and measuring the change in haemoglobin levels in elderly patients with anaemia were included. Titles and abstracts were reviewed and publications were screened by both authors independently to exclude articles that did not satisfy the inclusion criteria. STUDY APPRAISAL AND SYNTHESIS Risk of bias was systematically assessed independently by both authors using the Cochrane risk of bias tool. Data on the increase in haemoglobin level after therapy was either collected from original publications or by contacting the corresponding authors. Length of hospitalisation, mortality and adverse effect data were also analysed. RESULTS A total of 6,163 citations were screened, but only three studies (a total of 440 participants with a mean age ranging between 70 and 83 years) met the inclusion criteria. Meta-analysis showed oral iron supplementation increased haemoglobin levels more than placebo or no treatment after 4-6 weeks of treatment (mean difference 0.35 g/dL, 95 % CI 0.12-0.59, p = 0.003). There were no statistically significant differences in adverse effects, length of hospitalisation or mortality. LIMITATIONS Only one of the three studies was specific to older people and all studies involved patients in orthopaedic settings. The mean age of participants was different, and the dosage and frequency of ferrous sulphate differed. CONCLUSION Oral iron raises haemoglobin levels in elderly people with iron deficiency anaemia by 0.35 g/dL after 4-6 weeks, but it is unclear if this results in tangible health benefits.
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Affiliation(s)
- Hui Sian Tay
- Department of Medicine for the Elderly, Ward 102, Aberdeen Royal Infirmary, NHS Grampian, Foresterhill Road, Aberdeen, AB, 25 2ZN, UK,
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Arredondo S. P, Barrero C, Garcia K, Greneche J. Enhancing the possibilities of 57 Fe Mössbauer spectrometry to the study of chemical and physical properties of iron in medicines. Polyhedron 2016. [DOI: 10.1016/j.poly.2015.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Xiao C, Lei X, Wang Q, Du Z, Jiang L, Chen S, Zhang M, Zhang H, Ren F. Effects of a Tripeptide Iron on Iron-Deficiency Anemia in Rats. Biol Trace Elem Res 2016; 169:211-7. [PMID: 26109335 DOI: 10.1007/s12011-015-0412-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 06/12/2015] [Indexed: 10/23/2022]
Abstract
This study aims to investigate the effects of a tripeptide iron (REE-Fe) on iron-deficiency anemia rats. Sprague-Dawley rats were randomly divided into seven groups: a normal control group, an iron-deficiency control group, and iron-deficiency groups treated with ferrous sulfate (FeSO4), ferrous glycinate (Fe-Gly), or REE-Fe at low-, medium-, or high-dose groups. The rats in the iron-deficiency groups were fed on an iron-deficient diet to establish iron-deficiency anemia (IDA) model. After the model established, different iron supplements were given to the rats once a day by intragastric administration for 21 days. The results showed that REE-Fe had effective restorative action returning body weight, organ coefficients, and hematological parameters in IDA rats to normal level. In addition, comparing with FeSO4 or Fe-Gly, high-dose REE-Fe was more effective on improving the levels of renal coefficient, total iron-binding capacity, and transferrin. Furthermore, the liver hepcidin messenger RNA (mRNA) expression in the high-dose group was significantly higher (p < 0.05) than that in the FeSO4 or Fe-Gly group and showed no significant difference (p > 0.05) with the normal control group. The findings suggest that REE-Fe is an effective source of iron supplement for IDA rats and might be exploited as a new iron fortifier.
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Affiliation(s)
- Chen Xiao
- Beijing Laboratory of Food Quality and Safety, and Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, P.O. Box 287, No. 17 Qinghua East Road, Haidian, Beijing, 100083, People's Republic of China
| | - Xingen Lei
- Department of Animal Science, Cornell University, Ithaca, NY, 14853, USA
| | - Qingyu Wang
- Beijing Laboratory of Food Quality and Safety, and Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, P.O. Box 287, No. 17 Qinghua East Road, Haidian, Beijing, 100083, People's Republic of China
| | - Zhongyao Du
- Beijing Laboratory of Food Quality and Safety, and Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, P.O. Box 287, No. 17 Qinghua East Road, Haidian, Beijing, 100083, People's Republic of China
| | - Lu Jiang
- Beijing Laboratory of Food Quality and Safety, and Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, P.O. Box 287, No. 17 Qinghua East Road, Haidian, Beijing, 100083, People's Republic of China
| | - Silu Chen
- Beijing Laboratory of Food Quality and Safety, and Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, P.O. Box 287, No. 17 Qinghua East Road, Haidian, Beijing, 100083, People's Republic of China
| | - Mingjie Zhang
- Beijing Higher Institution Engineering Research Center of Animal Product, Beijing, 100083, People's Republic of China
| | - Hao Zhang
- Beijing Laboratory of Food Quality and Safety, and Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, P.O. Box 287, No. 17 Qinghua East Road, Haidian, Beijing, 100083, People's Republic of China.
| | - Fazheng Ren
- Beijing Laboratory of Food Quality and Safety, and Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, P.O. Box 287, No. 17 Qinghua East Road, Haidian, Beijing, 100083, People's Republic of China
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Orozco C J, Vargas G C, Rojas B ML, Herrera AM, Montoya V L, Sánchez G J, Chica P J, Villada O O, Díaz D A. Efecto de los micronutrientes en polvo en el estado nutricional y en los valores hemáticos de preescolares sanos, Medellín, 2013. REVISTA FACULTAD NACIONAL DE SALUD PÚBLICA 2015. [DOI: 10.17533/udea.rfnsp.v33n2a03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Gurusamy KS, Nagendran M, Broadhurst JF, Anker SD, Richards T. Iron therapy in anaemic adults without chronic kidney disease. Cochrane Database Syst Rev 2014; 2014:CD010640. [PMID: 25550190 PMCID: PMC10891481 DOI: 10.1002/14651858.cd010640.pub2] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Anaemia affects about a quarter of the world's population. An estimated 50% of anaemic people have anaemia due to iron deficiency. OBJECTIVES To assess the safety and efficacy of iron therapies for the treatment of adults with anaemia who are not pregnant or lactating and do not have chronic kidney disease. SEARCH METHODS We ran the search on 11 July 2013. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE (Ovid SP), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus (EBSCO Host), the Institute for Scientific Information Web of Science (ISI WOS) Scientific Citation Index (SCI)-EXPANDED (1970) and Conference Proceedings Citation Index (CPCI)-Science (1990) and Clinicaltrials.gov; we also screened reference lists. An updated search was run on 24 November 2014 but the results have not yet been incorporated into the review. SELECTION CRITERIA Two review authors independently selected references for further assessment by going through all titles and abstracts. Further selection was based on review of full-text articles for selected references. DATA COLLECTION AND ANALYSIS Two review authors independently extracted study data. We calculated the risk ratio (RR) with 95% confidence interval (CI) for binary outcomes and the mean difference (MD) or the standardised mean difference (SMD) with 95% CI for continuous outcomes. We performed meta-analysis when possible, when I(2) was less than or equal to 80% using a fixed-effect or random-effects model, using Review Manager software. The range of point estimates for individual studies is presented when I(2) > 80%. MAIN RESULTS We included in this systematic review 4745 participants who were randomly assigned in 21 trials. Trials were conducted in a wide variety of clinical settings. Most trials included participants with mild to moderate anaemia and excluded participants who were allergic to iron therapy. All trials were at high risk of bias for one or more domains. We compared both oral iron and parenteral iron versus inactive controls and compared different iron preparations.The comparison between oral iron and inactive control revealed no evidence of clinical benefit in terms of mortality (RR 1.05, 95% CI 0.68 to 1.61; four studies, N = 659; very low-quality evidence). The point estimate of the mean difference in haemoglobin levels in individual studies ranged from 0.3 to 3.1 g/dL higher in the oral iron group than in the inactive control group. The proportion of participants who required blood transfusion was lower with oral iron than with inactive control (RR 0.74, 95% CI 0.55 to 0.99; three studies, N = 546; very low-quality evidence). Evidence was inadequate for determination of the effect of parenteral iron on mortality versus oral iron (RR 1.49, 95% CI 0.56 to 3.94; 10 studies, N = 2141; very low-quality evidence) or inactive control (RR 1.04, 95% CI 0.63 to 1.69; six studies, N = 1009; very low-quality evidence). Haemoglobin levels were higher with parenteral iron than with oral iron (MD -0.50 g/dL, 95% CI -0.73 to -0.27; six studies, N = 769; very low-quality evidence). The point estimate of the mean difference in haemoglobin levels in individual studies ranged between 0.3 and 3.0 g/dL higher in the parenteral iron group than in the inactive control group. Differences in the proportion of participants requiring blood transfusion between parenteral iron and oral iron groups (RR 0.61, 95% CI 0.24 to 1.58; two studies, N = 371; very low-quality evidence) or between parenteral iron groups and inactive controls (RR 0.84, 95% CI 0.66 to 1.06; eight studies, N = 1315; very low-quality evidence) were imprecise. Average blood volume transfused was less in the parenteral iron group than in the oral iron group (MD -0.54 units, 95% CI -0.96 to -0.12; very low-quality evidence) based on one study involving 44 people. Differences between therapies in quality of life or in the proportion of participants with serious adverse events were imprecise (very low-quality evidence). No trials reported severe allergic reactions due to parenteral iron, suggesting that these are rare. Adverse effects related to oral iron treatment included nausea, diarrhoea and constipation; most were mild.Comparisons of one iron preparation over another for mortality, haemoglobin or serious adverse events were imprecise. No information was available on quality of life. Thus, little evidence was found to support the use of one preparation or regimen over another.Subgroup analyses did not reveal consistent results; therefore we were unable to determine whether iron is useful in specific clinical situations, or whether iron therapy might be useful for people who are receiving erythropoietin. AUTHORS' CONCLUSIONS • Very low-quality evidence suggests that oral iron might decrease the proportion of people who require blood transfusion, and no evidence indicates that it decreases mortality. Oral iron might be useful in adults who can tolerate the adverse events, which are usually mild.• Very low-quality evidence suggests that intravenous iron results in a modest increase in haemoglobin levels compared with oral iron or inactive control without clinical benefit.• No evidence can be found to show any advantage of one iron preparation or regimen over another.• Additional randomised controlled trials with low risk of bias and powered to measure clinically useful outcomes such as mortality, quality of life and blood transfusion requirements are needed.
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Affiliation(s)
- Kurinchi Selvan Gurusamy
- Royal Free Campus, UCL Medical SchoolDepartment of SurgeryRoyal Free HospitalRowland Hill StreetLondonUKNW3 2PF
| | - Myura Nagendran
- Department of SurgeryUCL Division of Surgery and Interventional Science9th Floor, Royal Free HospitalPond StreetLondonUKNW3 2QG
| | - Jack F Broadhurst
- University College LondonDivision of MedicineGower StreetLondonGreater LondonUKWC1E 6BT
| | - Stefan D Anker
- University Medical Centre GöttingenInnovative Clinical TrialsGöttingenGermany
| | - Toby Richards
- Royal Free Campus, UCL Medical SchoolDepartment of SurgeryRoyal Free HospitalRowland Hill StreetLondonUKNW3 2PF
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Xu C, Dong C, Xu C, Han T, Bao S, Gao X. Effect of iron supplementation on the expression of hypoxia-inducible factor and antioxidant status in rats exposed to high-altitude hypoxia environment. Biol Trace Elem Res 2014; 162:142-52. [PMID: 25380676 DOI: 10.1007/s12011-014-0166-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 10/28/2014] [Indexed: 12/18/2022]
Abstract
Iron and oxygen are essential substance for cellular activity in body tissues. Hypoxia-inducible factors (HIFs) can respond to available oxygen changes in the cellular environment and regulate the transcription of a series of target genes. The study was conducted to investigate the effects of iron supplementation on the expression of hypoxia-inducible factor-1 alpha (HIF-1α) and antioxidant status in rats exposed to high-altitude hypoxia environment. Forty rats were divided into control (CON), hypobaric hypoxia (HH), and hypobaric hypoxia plus ferrous sulfate (FeSO4) (9.93 mg/kg body weight (BW)/day) (HFS) and hypobaric hypoxia plus iron glycinate chelate (Fe-Gly) (11.76 mg/kg BW/day) (HFG) groups. Results showed that Fe-Gly effectively alleviated weight loss and intestinal mucosa damage induced by hypobaric hypoxia, whereas FeSO4 aggravated hypobaric hypoxia-induced weight loss, liver enlargement, spleen atrophy, and intestinal damage. Iron supplementation decreased liver superoxide dismutase (T-SOD) and catalase (CAT) activity (P < 0.01) and increased iron concentration in the liver compared to HH group (P < 0.001). Moreover, Fe-Gly upregulated liver transferrin expression in messenger RNA (mRNA) level (P < 0.05) and downregulated serum erythropoietin (EPO) concentration (P < 0.01) and liver HIF-1α expression level (P < 0.05 in mRNA level; P < 0.001 in protein level) compared to HH group. The study indicated that FeSO4 supplementation at high altitudes aggravated the oxidative damage of tissues and organs that could be mediated through production of malondialdehyde (MDA) and inhibition antioxidant enzyme activities. Fe-Gly can protect hypobaric hypoxia-induced tissues injury. Moreover, iron supplementation at high altitudes affected HIF-1α-mediated regulating expression of targeting genes such as EPO and transferrin. The study highlights that iron supplementation under hypobaric hypoxia environment has possible limitation, and efficient supplementation form and dosage need careful consideration.
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Affiliation(s)
- Chunlan Xu
- The Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, 127 West Youyixi Road, Xi'an, Shaanxi, 710072, People's Republic of China,
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Toxqui L, Pérez-Granados AM, Blanco-Rojo R, Wright I, González-Vizcayno C, Vaquero MP. Effects of an Iron or Iron and Vitamin D–Fortified Flavored Skim Milk on Iron Metabolism: A Randomized Controlled Double-Blind Trial in Iron-Deficient Women. J Am Coll Nutr 2013; 32:312-20. [DOI: 10.1080/07315724.2013.826116] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Santarpia L, Pagano MC, Cuomo R, Alfonsi L, Contaldo F, Pasanisi F. Iron absorption following a single oral dose of ferrous sulfate or ferric gluconate in patients with gastrectomy. ANNALS OF NUTRITION AND METABOLISM 2013; 63:55-9. [PMID: 23899667 DOI: 10.1159/000351447] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 04/13/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Iron deficiency anemia frequently occurs in gastrectomized patients. METHODS Serum iron levels following the ingestion of a single oral dose of 105 mg elemental iron, taken as ferrous sulfate (FeS) or ferric gluconate (FeG), have been evaluated in 20 gastrectomized patients (and 20 controls). All subjects participated on 2 different test days, 1 month apart: they took a single dose of 105 mg elemental iron as FeS or FeG after a night of fasting. Serum iron concentrations at baseline, 30, 60, 120 and 180 min after the oral dose administration were measured. RESULTS In patients and controls receiving FeG, serum iron levels did not significantly change. After oral ingestion of FeS, patients' serum iron levels gradually increased. The increase in serum iron levels was 148 and 168% at 120 and 180 min in patients (p < 0.0001 for both evaluations), whilst in controls, it was 216% at 120 min and 234% at 180 min, i.e. significantly higher than in gastrectomized patients (p < 0.001 for both evaluations). CONCLUSIONS In gastrectomized patients, a single oral dose of FeS shows a significant increase in iron serum concentration, albeit lower than in controls. Further studies on a larger sample of patients will be necessary to confirm these results.
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Affiliation(s)
- L Santarpia
- Internal Medicine and Clinical Nutrition Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
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Ferrari P, Nicolini A, Manca ML, Rossi G, Anselmi L, Conte M, Carpi A, Bonino F. Treatment of mild non-chemotherapy-induced iron deficiency anemia in cancer patients: comparison between oral ferrous bisglycinate chelate and ferrous sulfate. Biomed Pharmacother 2012; 66:414-8. [PMID: 22795809 DOI: 10.1016/j.biopha.2012.06.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 06/10/2012] [Indexed: 12/18/2022] Open
Abstract
In cancer patients mild-moderate non-chemotherapy-induced iron deficiency anemia (IDA) is usually treated with oral iron salts, mostly ferrous sulfate. In this study, we compare efficacy and toxicity of oral ferrous bisglycinate chelate and ferrous sulfate in cancer patients with mild IDA. Twenty-four patients operated on for solid tumors (10 breast, 12 colorectal, 2 gastric), aged 61±10 years (range 45-75), with non-chemotherapy-induced hemoglobin (Hb) values between 10 and 12 g/dL and ferritin lower than 30 ng/mL were randomized to receive oral ferrous bisglycinate chelate, 28 mg per day for 20 days, and then 14 mg per day for 40 days (12 patients) (A group) or oral ferrous sulphate, 105 mg per day for 60 days (12 patients) (B group). Values of hemoglobin and ferritin obtained at diagnosis, 1 and 2 months from the beginning of treatment were compared. Adverse events (AEs) related to the two treatments were recorded. In the 12 patients treated with ferrous bisglycinate chelate, basal hemoglobin and ferritin values (mean±SD) were 11.6±0.8 g/dL and 16.1±8.0 ng/mL. After 2 months of treatment, they were 13.0±1.4 g/dL and 33.8±22.0 ng/mL, respectively (P=0.0003 and P=0.020). In the group treated with ferrous sulphate, hemoglobin and ferritin mean values were 11.3±0.6 g/dL and 19.0±6.4 ng/mL basally, and 12.7±0.70 g/dL and 40.8±28.1 ng/mL (P<0.0001 and P=0.017) after 2 months of treatment. AEs occurred in six cases. In all these six cases, two (17%) treated with ferrous bisglycinate chelate and four (33%) with ferrous sulphate, toxicity was grade 1. In conclusion, these data suggest that ferrous bisglycinate chelate has similar efficacy and likely lower GI toxicity than ferrous sulphate given at the conventional dose of 105 mg per day for the same time.
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Affiliation(s)
- Paola Ferrari
- Department of Oncology, University of Pisa, Pisa, Italy.
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Aspuru K, Villa C, Bermejo F, Herrero P, López SG. Optimal management of iron deficiency anemia due to poor dietary intake. Int J Gen Med 2011; 4:741-50. [PMID: 22114518 PMCID: PMC3219760 DOI: 10.2147/ijgm.s17788] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Iron is necessary for the normal development of multiple vital processes. Iron deficiency (ID) may be caused by several diseases, even by physiological situations that increase requirements for this mineral. One of its possible causes is a poor dietary iron intake, which is infrequent in developed countries, but quite common in developing areas. In these countries, dietary ID is highly prevalent and comprises a real public health problem and a challenge for health authorities. ID, with or without anemia, can cause important symptoms that are not only physical, but can also include a decreased intellectual performance. All this, together with a high prevalence, can even have negative implications for a community’s economic and social development. Treatment consists of iron supplements. Prevention of ID obviously lies in increasing the dietary intake of iron, which can be difficult in developing countries. In these regions, foods with greater iron content are scarce, and attempts are made to compensate this by fortifying staple foods with iron. The effectiveness of this strategy is endorsed by multiple studies. On the other hand, in developed countries, ID with or without anemia is nearly always associated with diseases that trigger a negative balance between iron absorption and loss. Its management will be based on the treatment of underlying diseases, as well as on oral iron supplements, although these latter are limited by their tolerance and low potency, which on occasions may compel a change to intravenous administration. Iron deficiency has a series of peculiarities in pediatric patients, in the elderly, in pregnant women, and in patients with dietary restrictions, such as celiac disease.
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Affiliation(s)
- Kattalin Aspuru
- Digestive Department, Hospital Universitario Miguel Servet (Miguel Servet University Hospital), Zaragoza
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Baker A, Wooten LA, Malloy M. Nutritional considerations after gastrectomy and esophagectomy for malignancy. Curr Treat Options Oncol 2011; 12:85-95. [PMID: 21264689 DOI: 10.1007/s11864-010-0134-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This article reviews various methods of assessing and managing post-gastrectomy or esophagectomy patients from a nutritional standpoint, by examining recent research focusing on assessment models, components of enteral feeding, timing of feeding, safety of enteral nutrition (EN) vs total parenteral nutrition (TPN), appetite stimulants, alternative treatments, and long-term care. Pre-, peri-, and post-operative nutrition represent a major prognostic indicator in patients undergoing a gastrectomy or esophagectomy for malignant cancer. An accurate initial nutrition assessment to determine risk, followed by close monitoring pre-operatively and early enteral feeding post-operatively, has been shown to have the most beneficial effects. The optimal delivery route for nutrition involves the use of EN with immune enhancing nutrients while avoiding TPN. In practice, TPN is reserved for patients with post-operative complications that delay enteral feeding for an extended time. While megace is commonly used as an appetite stimulant, the hormone ghrelin is another novel, safe, and efficacious treatment to improve appetite, increase by mouth (PO) intake, and minimize loss of weight and lean body mass. Although use of ghrelin is not yet common practice, as more studies are published, we predict that this will become a more common treatment. While complementary and alternative therapies are commonly employed in this patient population, more research needs to be done before incorporation into our mainstay of treatment. Long term, these patients continue to be at nutritional risk and therefore should be followed to optimize weight maintenance and prevent micronutrient deficiencies.
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Affiliation(s)
- Amelia Baker
- Georgetown University Hospital, Washington, DC 20057, USA.
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Madrazo González Z, García Barrasa A, Rafecas Renau A. Anemia, hierro, transfusión y alternativas terapéuticas. Revisión desde una perspectiva quirúrgica. Cir Esp 2010; 88:358-68. [DOI: 10.1016/j.ciresp.2010.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2009] [Revised: 11/27/2009] [Accepted: 03/12/2010] [Indexed: 12/31/2022]
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Abstract
PURPOSE OF REVIEW Iron deficiency anemia (IDA) still remains universally problematic worldwide. The primary focus of this review is to critique articles published over the past 18 months that describe strategies for the diagnosis and management of this prevalent condition. RECENT FINDINGS The medical community continues to lack consensus when identifying the optimal approach for the diagnosis and management of IDA. Current diagnostic recommendations revolve around the validity and practicality of current biomarkers such as soluble transferrin-receptor concentrations and others, and cause-based diagnostics that potentially include endoscopy. Management of IDA is based on supplementation combined with effective etiological treatment. Advances in oral and parenteral low-molecular-weight iron preparations has expanded and improved treatment modalities for IDA. Since the introduction of low versus high-molecular-weight intravenous iron administration, there have been fewer serious adverse events associated with parenteral iron preparations. SUMMARY Best practice guidelines for diagnosing and managing IDA should include the design of an algorithm that is inclusive of multiple biomarkers and cause-based diagnostics, which will provide direction in managing IDA, and distinguish between IDA from the anemia of chronic disease.
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