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Roth-Walter F, Berni Canani R, O'Mahony L, Peroni D, Sokolowska M, Vassilopoulou E, Venter C. Nutrition in chronic inflammatory conditions: Bypassing the mucosal block for micronutrients. Allergy 2024; 79:353-383. [PMID: 38084827 DOI: 10.1111/all.15972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 02/01/2024]
Abstract
Nutritional Immunity is one of the most ancient innate immune responses, during which the body can restrict nutrients availability to pathogens and restricts their uptake by the gut mucosa (mucosal block). Though this can be a beneficial strategy during infection, it also is associated with non-communicable diseases-where the pathogen is missing; leading to increased morbidity and mortality as micronutritional uptake and distribution in the body is hindered. Here, we discuss the acute immune response in respect to nutrients, the opposing nutritional demands of regulatory and inflammatory cells and particularly focus on some nutrients linked with inflammation such as iron, vitamins A, Bs, C, and other antioxidants. We propose that while the absorption of certain micronutrients is hindered during inflammation, the dietary lymph path remains available. As such, several clinical trials investigated the role of the lymphatic system during protein absorption, following a ketogenic diet and an increased intake of antioxidants, vitamins, and minerals, in reducing inflammation and ameliorating disease.
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Affiliation(s)
- Franziska Roth-Walter
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Roberto Berni Canani
- Department of Translational Medical Science and ImmunoNutritionLab at CEINGE-Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Liam O'Mahony
- Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Diego Peroni
- Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
- Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Emilia Vassilopoulou
- Pediatric Area, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Carina Venter
- Children's Hospital Colorado, University of Colorado, Aurora, Colorado, USA
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Brittenham GM, Moir-Meyer G, Abuga KM, Datta-Mitra A, Cerami C, Green R, Pasricha SR, Atkinson SH. Biology of Anemia: A Public Health Perspective. J Nutr 2023; 153 Suppl 1:S7-S28. [PMID: 37778889 DOI: 10.1016/j.tjnut.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/04/2023] [Accepted: 07/31/2023] [Indexed: 10/03/2023] Open
Abstract
Our goal is to present recent progress in understanding the biological mechanisms underlying anemia from a public health perspective. We describe important advances in understanding common causes of anemia and their interactions, including iron deficiency (ID), lack of other micronutrients, infection, inflammation, and genetic conditions. ID develops if the iron circulating in the blood cannot provide the amounts required for red blood cell production and tissue needs. ID anemia develops as iron-limited red blood cell production fails to maintain the hemoglobin concentration above the threshold used to define anemia. Globally, absolute ID (absent or reduced body iron stores that do not meet the need for iron of an individual but may respond to iron supplementation) contributes to only a limited proportion of anemia. Functional ID (adequate or increased iron stores that cannot meet the need for iron because of the effects of infection or inflammation and does not respond to iron supplementation) is frequently responsible for anemia in low- and middle-income countries. Absolute and functional ID may coexist. We highlight continued improvement in understanding the roles of infections and inflammation in causing a large proportion of anemia. Deficiencies of nutrients other than iron are less common but important in some settings. The importance of genetic conditions as causes of anemia depends upon the specific inherited red blood cell abnormalities and their prevalence in the settings examined. From a public health perspective, each setting has a distinctive composition of components underlying the common causes of anemia. We emphasize the coincidence between regions with a high prevalence of anemia attributed to ID (both absolute and functional), those with endemic infections, and those with widespread genetic conditions affecting red blood cells, especially in sub-Saharan Africa and regions in Asia and Oceania.
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Affiliation(s)
- Gary M Brittenham
- Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY, United States.
| | - Gemma Moir-Meyer
- Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - Kelvin Mokaya Abuga
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Ananya Datta-Mitra
- Department of Pathology and Laboratory Medicine, University of California, Davis, CA, United States
| | - Carla Cerami
- The Medical Research Council Unit, The Gambia, London School of Hygiene and Tropical Medicine, London, UK
| | - Ralph Green
- Department of Pathology and Laboratory Medicine, University of California, Davis, CA, United States
| | - Sant-Rayn Pasricha
- Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia; Diagnostic Haematology, The Royal Melbourne Hospital; and Clinical Haematology at the Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Parkville, VIC Australia
| | - Sarah H Atkinson
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Paediatrics, University of Oxford, Oxford, UK
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Ramasamy J, Jagadish C, Sukumaran A, Varghese J, Mani T, Joseph AJ, Simon EG, Jacob M. Low Serum Hepcidin Levels in Patients with Ulcerative Colitis - Implications for Treatment of Co-existent Iron-Deficiency Anemia. Inflammation 2023; 46:2209-2222. [PMID: 37486527 DOI: 10.1007/s10753-023-01872-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 07/25/2023]
Abstract
Ulcerative colitis (UC) is often associated with anemia. Hepcidin, the central regulator of iron homeostasis, is known to be induced by inflammation and suppressed by anemia. It is not clear how hepcidin is affected in those with UC, when both inflammation and anemia may co-exist.Such knowledge may hold implications for treatment. Hematological and iron-related parameters, C-reactive protein (CRP), growth differentiation factor 15 (GDF-15) and erythroferrone (ERFE) (erythroid regulators of hepcidin) levels were estimated in blood from those with UC and in control subjects. Values for hematological and iron-related parameters showed evidence of iron-deficiency and resultant anemia, in patients with UC. The presence of UC was significantly associated with inflammation. Serum levels of ERFE, but not of GDF-15, were significantly higher in patients with UC than in control patients, while hepcidin levels were significantly lower. Serum hepcidin concentrations in patients with UC correlated positively with serum iron, ferritin and GDF-15, and negatively with serum ERFE. The iron status and serum hepcidin levels in UC patients with co-existent anemia were significantly lower and serum ERFE values significantly higher than in those with UC without anemia. The effect of anemia on hepcidin predominated over that of inflammation in patients with UC, resulting in suppressed hepcidin levels. This effect is possibly mediated through erythroferrone. We suggest that a serum hepcidin-guided approach may be useful to guide use of oral iron supplements to treat co-existent iron-deficiency anemia in patients with UC and other chronic inflammatory diseases.
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Affiliation(s)
- Jagadish Ramasamy
- Department of Biochemistry, Christian Medical College, Vellore, Tamil Nadu, 632002, India
- Department of Biochemistry, Velammal Medical College Hospital and Research Institute, Madurai, Tamil Nadu, 625009, India
| | - Chinmai Jagadish
- Department of Biochemistry, Christian Medical College, Vellore, Tamil Nadu, 632002, India
- Department of Biochemistry, Dr. Chandramma Dayanada Sagar Institute of Medical Education and Research, Deverakaggalahalli, Karnataka, 562112, India
| | - Abitha Sukumaran
- Department of Biochemistry, Christian Medical College, Vellore, Tamil Nadu, 632002, India
- Division of Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Joe Varghese
- Department of Biochemistry, Christian Medical College, Vellore, Tamil Nadu, 632002, India
| | - Thenmozhi Mani
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, 632002, India
| | - A J Joseph
- Department of Gastroenterology, Christian Medical College and Hospital, Vellore, Tamil Nadu, 632002, India
| | - Ebby George Simon
- Department of Gastroenterology, Christian Medical College and Hospital, Vellore, Tamil Nadu, 632002, India
| | - Molly Jacob
- Department of Biochemistry, Christian Medical College, Vellore, Tamil Nadu, 632002, India.
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Ritter F, Staub BM, Osthoff M. Appropriateness of inpatient intravenous iron therapy in a Swiss tertiary care hospital. Eur J Haematol 2023; 111:601-610. [PMID: 37489058 DOI: 10.1111/ejh.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION Intravenous (IV) iron replacement is an established treatment for iron deficiency and is recommended in various medical guidelines, but cheaper oral iron formulations remain first-line therapy in several instances. Data on adherence to current prescription standards are lacking in Switzerland. METHODS Retrospective single center quality control study evaluating the appropriateness of IV iron replacement in 400 inpatients during 2019 and 2021 at a Swiss tertiary care hospital. Appropriateness of IV iron was assessed by expert chart review according to national and international guidelines. RESULTS IV iron prescriptions were assessed as inappropriate in 147 (37%) of cases (indication lacking in 13%, oral route preferred in 24%). Inappropriate prescribing was more common (p < .001) in surgical wards (66%) compared to medical units (48%) and the gynecologic ward (19%). Iron studies were lacking in 29% of inappropriate IV administrations. Insufficient replacement dosages were chosen in 38% of patients with appropriate prescription. CONCLUSION Based on current guidelines, inappropriate in-hospital prescription of IV iron was frequently observed. Considerable differences exist between hospital units, which are consistent with conflicting recommendations of professional societies. We recommend increased attention toward the prescription quality to avoid unnecessary, expensive, and potentially harmful use of IV iron.
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Affiliation(s)
- Fabian Ritter
- Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
- Division of Internal Medicine, Kantonsspital Baselland, Liestal, Switzerland
| | - Benjamin M Staub
- Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Michael Osthoff
- Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
- Division of Internal Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
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Waworuntu W, Tanoerahardjo FS, Mallongi A, Ahmad A, Amin M, Djaharuddin I, Bukhari A, Tabri NA, Bahar B, Hidayah N, Halik H, Massi MN. Serum iron levels in tuberculosis patients and household contacts and its association with natural resistance-associated macrophage protein 1 polymorphism and expression. THE CLINICAL RESPIRATORY JOURNAL 2023; 17:893-904. [PMID: 37607533 PMCID: PMC10500328 DOI: 10.1111/crj.13677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 06/28/2023] [Accepted: 07/19/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Iron deficiency can impair immune function, increasing tuberculosis (TB) susceptibility and severity. The research aimed to investigate iron deficiency anemia in TB patients and household contacts and its association with natural resistance-associated macrophage protein 1 (NRAMP1) polymorphism and expression. METHODS The levels of iron, ferritin, and transferrin were measured in the serum by ELISA (Enzyme-Linked Immunosorbent Assay). NRAMP1 polymorphisms were determined by polymerase chain reaction (PCR) and sequencing. NRAMP1 gene expression was measured by real-time PCR. Interferon-gamma release assay (IGRA) checked on household contacts to screen household contacts with positive IGRA as the control. RESULTS This study involved 35 TB cases and 35 TB contacts. The results showed that the serum Fe levels were found to be lower in the TB case group (median 149.6 μmol/L) than in the positive IGRA household contacts group (median 628.53 μmol/L) with a p-value <0.001. Meanwhile, ferritin levels in TB cases tended to be higher, in contrast to transferrin, which was found to tend to be lower in TB cases than household contacts but did not show a significant difference. This study found no association between the polymorphism of exon 15 D543 and active TB. However, NRAMP1 gene expression was lower in TB cases than in positive IGRA household contacts (p = 0.011). Besides, there was a positive correlation between NRAMP1 gene expression and serum Fe levels (r = 0.367, p = 0.006). TB was associated with decreased NRAMP1 gene expression (OR 0.086 95% CI 0.02-0.366, p = 0.001). Besides, TB was associated with low Fe levels (OR 0.533 95% CI 0.453-0.629, p < 0.001). CONCLUSION Comparing the TB case to the household contacts group, decreased serum Fe levels were discovered in the TB case group. This study also shows a correlation of NRAMP1 gene expression to Fe levels in TB patients and household contacts and describes that TB may lead to decreased Fe levels by downregulating NRAMP1 expression.
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Affiliation(s)
- Wiendra Waworuntu
- Pusat Kebijakan Sumber Daya dan Sistem Ketahanan Kesehatan, Badan Kebijakan Pembangunan KesehatanMinistry of Health Republic IndonesiaJakartaIndonesia
- Postgraduate Program, Faculty of Medicine, Universitas HasanuddinMakassarSouth SulawesiIndonesia
| | | | - Anwar Mallongi
- Department of Environmental Health, Faculty of Public HealthUniversitas HasanuddinMakassarSouth SulawesiIndonesia
| | - Ahyar Ahmad
- Department of Chemistry, Faculty of Mathematics and Natural SciencesUniversitas HasanuddinMakassarSouth SulawesiIndonesia
| | - Muhammad Amin
- Department of Pulmonology and Respiratory Diseases, Faculty of MedicineUniversitas AirlanggaSurabayaWest JavaIndonesia
| | - Irawaty Djaharuddin
- Department of Pulmonology and Respiratory Diseases, Faculty of MedicineUniversitas HasanuddinMakassarSouth SulawesiIndonesia
- Dr. Wahidin Sudirohusodo HospitalMakassarSouth SulawesiIndonesia
| | - Agussalim Bukhari
- Department of Clinical Nutrition, Faculty of MedicineUniversitas HasanuddinMakassarSouth SulawesiIndonesia
| | - Nur Ahmad Tabri
- Department of Pulmonology and Respiratory Diseases, Faculty of MedicineUniversitas HasanuddinMakassarSouth SulawesiIndonesia
- Dr. Wahidin Sudirohusodo HospitalMakassarSouth SulawesiIndonesia
| | - Burhanuddin Bahar
- Department of Nutrition Sciences, Faculty of Public HealthHasanuddin UniversityMakassarIndonesia
| | - Najdah Hidayah
- Research Center for Vaccine and DrugsNational Research and Innovation Agency (BRIN)Tangerang SelatanBantenIndonesia
| | - Handayani Halik
- Postgraduate Program, Faculty of Medicine, Universitas HasanuddinMakassarSouth SulawesiIndonesia
- Hasanuddin University Medical Research Center Laboratory, Faculty of MedicineUniversitas HasanuddinMakassarSouth SulawesiIndonesia
| | - Muhammad Nasrum Massi
- Hasanuddin University Medical Research Center Laboratory, Faculty of MedicineUniversitas HasanuddinMakassarSouth SulawesiIndonesia
- Department of Clinical Microbiology, Faculty of MedicineUniversitas HasanuddinMakassarSouth SulawesiIndonesia
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Carson JL, Brittenham GM. How I treat anemia with red blood cell transfusion and iron. Blood 2023; 142:777-785. [PMID: 36315909 PMCID: PMC10485845 DOI: 10.1182/blood.2022018521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 11/07/2022] Open
Abstract
Severe anemia is commonly treated with red blood cell transfusion. Clinical trials have demonstrated that a restrictive transfusion strategy of 7 to 8 g/dL is as safe as a liberal transfusion strategy of 9 to 10 g/dL in many clinical settings. Evidence is lacking for subgroups of patients, including those with preexisting coronary artery disease, acute myocardial infarction, congestive heart failure, and myelodysplastic neoplasms. We present 3 clinical vignettes that highlight the clinical challenges in caring for patients with coronary artery disease with gastrointestinal bleeding, congestive heart failure, or myelodysplastic neoplasms. We emphasize that transfusion practice should be guided by patient symptoms and preferences in conjunction with the patient's hemoglobin concentration. Along with the transfusion decision, evaluation and management of the etiology of the anemia is essential. Iron-restricted erythropoiesis is a common cause of anemia severe enough to be considered for red blood cell transfusion but diagnosis and management of absolute iron deficiency anemia, the anemia of inflammation with functional iron deficiency, or their combination may be problematic. Intravenous iron therapy is generally the treatment of choice for absolute iron deficiency in patients with complex medical disorders, with or without coexisting functional iron deficiency.
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Affiliation(s)
- Jeffrey L. Carson
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Gary M. Brittenham
- Departments of Pediatrics and Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
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Hilton C, Sabaratnam R, Drakesmith H, Karpe F. Iron, glucose and fat metabolism and obesity: an intertwined relationship. Int J Obes (Lond) 2023; 47:554-563. [PMID: 37029208 PMCID: PMC10299911 DOI: 10.1038/s41366-023-01299-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 03/08/2023] [Accepted: 03/16/2023] [Indexed: 04/09/2023]
Abstract
A bidirectional relationship exists between adipose tissue metabolism and iron regulation. Total body fat, fat distribution and exercise influence iron status and components of the iron-regulatory pathway, including hepcidin and erythroferrone. Conversely, whole body and tissue iron stores associate with fat mass and distribution and glucose and lipid metabolism in adipose tissue, liver, and muscle. Manipulation of the iron-regulatory proteins erythroferrone and erythropoietin affects glucose and lipid metabolism. Several lines of evidence suggest that iron accumulation and metabolism may play a role in the development of metabolic diseases including obesity, type 2 diabetes, hyperlipidaemia and non-alcoholic fatty liver disease. In this review we summarise the current understanding of the relationship between iron homoeostasis and metabolic disease.
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Affiliation(s)
- Catriona Hilton
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK.
| | - Rugivan Sabaratnam
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Hal Drakesmith
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
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Anwar MC, Budiono I, Putriningtyas ND, Nisa AA, Santjaka A, Suswandany DL. The efficacy of Bloso fish (Glossogobius giuris sp.) in improving hemoglobin, hematocrit, platelet, and albumin levels of Wistar rats with hypoalbuminemia. POTRAVINARSTVO 2023. [DOI: 10.5219/1847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Tuberculosis (TB) is an infectious disease worldwide that causes death. Common clinical manifestations of patients with TB include anemia, hypoalbuminemia, and malnutrition. Most patients with TB are infected with coccus bacteria, such as Staphylococcus aureus, that commonly attack the respiratory tract. However, the consumption of heme protein sources could improve the nutritional status of patients with TB. Fish comprise one of the most widely consumed sources of heme. The bloso fish (Glossogobius giuris sp.), considered a fish without economic value is a new alternative source of heme protein. This study aimed to develop supplements using bloso fish (Glossogobius giuris sp.). This study used an experimental pretest-post-test control group design. Seven male Wistar rats were used as the negative control group. Twenty- eight male Wistar rats were administered S. aureus, fed a protein-deficient diet, and divided into the positive control group, the K1 group, which received up to 675 mg/200 g of bloso fish flour, the K2 group, which received up to 67.5 mg/200 g of bloso fish oil, and the K3 group, which received up to 675 mg/200 g of bloso fish fluor from oil extraction dregs. Treatment was administered for 28 days. The hemoglobin (Hb), hematocrit (Ht), platelet, and albumin levels in blood serum from the retroorbital vein were measured. Data were processed using a paired t-test and one-way analysis of variance. The results showed differences in Hb, Ht, platelet, and albumin levels were observed before and after treatment. Additionally, differences in Hb, Ht, platelet, and albumin levels were observed in the groups that received bloso fish flour and bloso fish oil. Bloso fish flour and bloso fish oil increased the Hb, Ht, platelet, and albumin levels of rats with hypoalbuminemia.
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Nienaber A, Uyoga MA, Dolman-Macleod RC, Malan L. Iron Status and Supplementation during Tuberculosis. Microorganisms 2023; 11:microorganisms11030785. [PMID: 36985358 PMCID: PMC10055784 DOI: 10.3390/microorganisms11030785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Tuberculosis (TB) is characterised by chronic non-resolving inflammation. The effects of the host immune and inflammatory response to reduce iron acquisition by the bacteria, together with other contributing factors, predispose TB patients to anaemia of infection and iron deficiency anaemia (IDA). The presence of anaemia in TB patients has been linked to poor clinical outcomes. However, due to the reliance of the bacteria on iron, the management of anaemia in TB is complicated, and anaemia of infection is likely to resolve with correct TB drug treatment. On the other hand, IDA may require iron supplementation. This review aims to describe iron metabolism in TB and how this contributes to the development of iron deficiency and anaemia. Additionally, we summarise the evidence on the association between iron status and clinical outcomes as well as the available preclinical and clinical trials on iron supplementation in TB.
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Affiliation(s)
- Arista Nienaber
- Centre of Excellence for Nutrition, North-West University, Potchefstroom 2531, South Africa
| | - Mary A Uyoga
- Centre of Excellence for Nutrition, North-West University, Potchefstroom 2531, South Africa
| | - Robin C Dolman-Macleod
- Centre of Excellence for Nutrition, North-West University, Potchefstroom 2531, South Africa
| | - Linda Malan
- Centre of Excellence for Nutrition, North-West University, Potchefstroom 2531, South Africa
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Kaushik SR, Sahu S, Guha H, Saha S, Das R, Kupa RU, Kapfo W, Deka T, Basumatary R, Thong A, Dasgupta A, Goswami B, Pandey AK, Saikia L, Khamo V, Das A, Nanda RK. Low circulatory Fe and Se levels with a higher IL-6/IL-10 ratio provide nutritional immunity in tuberculosis. Front Immunol 2023; 13:985538. [PMID: 36713405 PMCID: PMC9878310 DOI: 10.3389/fimmu.2022.985538] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/28/2022] [Indexed: 01/15/2023] Open
Abstract
Tuberculosis (TB) patients show dysregulated immunity, iron metabolism, and anemia. In this study, circulatory cytokines, trace metals, and iron-related proteins (hepcidin, ferroportin, transferrin, Dmt1, Nramp1, ferritin, ceruloplasmin, hemojuvelin, aconitase, and transferrin receptor) were monitored in case (active tuberculosis patients: ATB) and control (non-tuberculosis: NTB and healthy) study populations (n = 72, male: 100%, mean age, 42.94 years; range, 17-83 years). Using serum elemental and cytokine levels, a partial least square discriminate analysis model (PLS-DA) was built, which clustered ATB patients away from NTB and healthy controls. Based on the PLS-DA variable importance in projection (VIP) score and analysis of variance (ANOVA), 13 variables were selected as important biosignatures [IL-18, IL-10, IL-13, IFN-γ, TNF-α, IL-5, IL-12 (p70), IL-1β, copper, zinc, selenium, iron, and aluminum]. Interestingly, low iron and selenium levels and high copper and aluminum levels were observed in ATB subjects. Low circulatory levels of transferrin, ferroportin, and hemojuvelin with higher ferritin and ceruloplasmin levels observed in ATB subjects demonstrate an altered iron metabolism, which partially resolved upon 6 months of anti-TB therapy. The identified biosignature in TB patients demonstrated perturbed iron homeostasis with anemia of inflammation, which could be useful targets for the development of host-directed adjunct therapeutics.
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Affiliation(s)
- Sandeep R. Kaushik
- Translational Health Group, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Sukanya Sahu
- Translational Health Group, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Hritusree Guha
- Department of Respiratory Medicine, Agartala Government Medical College, Agartala, Tripura, India
| | - Sourav Saha
- Department of Respiratory Medicine, Agartala Government Medical College, Agartala, Tripura, India
| | - Ranjit Das
- Department of Respiratory Medicine, Agartala Government Medical College, Agartala, Tripura, India
| | - Rukuwe-u Kupa
- Healthcare Laboratory and Research Centre, Naga Hospital Authority, Kohima, Nagaland, India
| | - Wetetsho Kapfo
- Healthcare Laboratory and Research Centre, Naga Hospital Authority, Kohima, Nagaland, India
| | - Trinayan Deka
- Department of Microbiology, Assam Medical College, Dibrugarh, Assam, India
| | - Rumi Basumatary
- Department of Microbiology, Assam Medical College, Dibrugarh, Assam, India
| | - Asunu Thong
- District Tuberculosis Centre, Kohima, Nagaland, India
| | - Arunabha Dasgupta
- Department of Medicine, Agartala Government Medical College, Agartala, Tripura, India
| | - Bidhan Goswami
- Department of Microbiology, Agartala Government Medical College, Agartala, Tripura, India
| | - Amit Kumar Pandey
- Mycobacterial Pathogenesis Laboratory, Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, India
| | - Lahari Saikia
- Department of Microbiology, Assam Medical College, Dibrugarh, Assam, India,Department of Microbiology, Gauhati Medical College, Guwahati, Assam, India
| | - Vinotsole Khamo
- Healthcare Laboratory and Research Centre, Naga Hospital Authority, Kohima, Nagaland, India
| | - Anjan Das
- Department of Respiratory Medicine, Agartala Government Medical College, Agartala, Tripura, India,*Correspondence: Ranjan Kumar Nanda, ; Anjan Das,
| | - Ranjan Kumar Nanda
- Translational Health Group, International Centre for Genetic Engineering and Biotechnology, New Delhi, India,*Correspondence: Ranjan Kumar Nanda, ; Anjan Das,
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Olaniran AF, Okonkwo CE, Iranloye YM, Morakinyo OO, Taiwo AE, Erinle OC, Bamidele OP, Ojo OA, Malomo AA, Osemwegie OO. Fermented Gluten-Free Multi-Grain Cereal Paste Development: The Role of the Orange-Fleshed Sweet Potato (OFSP) as a Dietary Supplement. Nutr Metab Insights 2023; 16:11786388231155007. [PMID: 36937079 PMCID: PMC10021086 DOI: 10.1177/11786388231155007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/16/2023] [Indexed: 03/17/2023] Open
Abstract
Vitamin A deficiencies is a becoming persistent among young children and a growing concern to parents in sub-Saharan Africa, especially in crisis-affected areas. Fermented cereal paste from maize, millets, and sorghum grains are significant food for young children. Thus, the study focuses on food fortification using orange-fleshed sweet potato (OFSP) as fortifier as studies have confirmed the presence of nutrients that can help meet the Vitamin A dietary requirement. The cereals were soaked ambient temperature (27 ± 1°C) for 72 hours and were blended with OFSP (90:10, 80:20, 70:30, 60:40, 50:50), and the formulated products were studied for Vitamin A, β-carotene, proximate composition, physicochemical, functional properties, and storage. Application of OFSP as forticant increased the Vitamin A (4.98-6.65 mg/100 g), β-carotene (0.10-0.17 mg/100 g) and the calorific value (222.03-301.75 kcal) of the gluten-free multi-grain cereal paste. The addition of OFSP also increased the ash content (1.41%-3.35%), crude fiber (2.56%-4.225%), carbohydrate (39.83%-48.35%), total solid content (55.20%-60.87%), and water absorption capacity (112.20%-137.49%) of the formulated cereal samples. The fortified fermented paste was objectively stable throughout on the shelf from the storage studies. The study deduced that addition of orange-fleshed sweet potato to fermented mixed cereal paste as a fortifier can help increase the nutritional quality of the complementary food.
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Affiliation(s)
- Abiola Folakemi Olaniran
- Department of Food Science and
Microbiology, College of Pure and Applied Sciences, Landmark University, Omu-Aran,
Kwara State, Nigeria
| | - Clinton Emeka Okonkwo
- Department of Food Science, College of
Food and Agriculture, United Arab Emirates University, Al Ain, United Arab
Emirates
| | - Yetunde Mary Iranloye
- Department of Food Science and
Microbiology, College of Pure and Applied Sciences, Landmark University, Omu-Aran,
Kwara State, Nigeria
| | - Olajumoke Olubunmi Morakinyo
- Department of Food Science and
Microbiology, College of Pure and Applied Sciences, Landmark University, Omu-Aran,
Kwara State, Nigeria
| | - Abiola Ezekiel Taiwo
- Faculty of Engineering, Mangosuthu
University of Technology, Durban, South Africa
| | - Oluwakemi Christianah Erinle
- Department of Agricultural and
Biosystems Engineering, College of Engineering, Landmark University, Omu-Aran, Kwara
State, Nigeria
| | | | - Oluwafemi Adeleke Ojo
- Department of Biochemistry, Bowen
University, Iwo, Osun State, Nigeria
- Oluwafemi Adeleke Ojo, Department of
Biochemistry, Bowen University, P.M.B. 284, Iwo, Osun State 232101, Nigeria.
| | - Adekunbi Adetola Malomo
- Department of Food Science and
Technology, Faculty of Technology, Obafemi Awolowo University, Ile-Ife, Osun State,
Nigeria
| | - Omorefosa Osarenkhoe Osemwegie
- Department of Food Science and
Microbiology, College of Pure and Applied Sciences, Landmark University, Omu-Aran,
Kwara State, Nigeria
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12
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De Souza LV, Hoffmann A, Fischer C, Petzer V, Asshoff M, Theurl I, Tymoszuk P, Seifert M, Brigo N, Hilbe R, Demetz E, Von Raffay L, Berger S, Barros-Pinkelnig M, Weiss G. Comparative analysis of oral and intravenous iron therapy in rat models of inflammatory anemia and iron deficiency. Haematologica 2023; 108:135-149. [PMID: 35796011 PMCID: PMC9827174 DOI: 10.3324/haematol.2022.281149] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/29/2022] [Indexed: 02/05/2023] Open
Abstract
Anemia is a major health issue and associated with increased morbidity. Iron deficiency anemia (IDA) is the most prevalent, followed by anemia of chronic disease (ACD). IDA and ACD often co-exist, challenging diagnosis and treatment. While iron supplementation is the first-line therapy for IDA, its optimal route of administration and the efficacy of different repletion strategies in ACD are elusive. Female Lewis rats were injected with group A streptococcal peptidoglycan-polysaccharide (PG-APS) to induce inflammatory arthritis with associated ACD and/or repeatedly phlebotomized and fed with a low iron diet to induce IDA, or a combination thereof (ACD/IDA). Iron was either supplemented by daily oral gavage of ferric maltol or by weekly intravenous (i.v.) injection of ferric carboxymaltose for up to 4 weeks. While both strategies reversed IDA, they remained ineffective to improve hemoglobin (Hb) levels in ACD, although oral iron showed slight amelioration of various erythropoiesis-associated parameters. In contrast, both iron treatments significantly increased Hb in ACD/IDA. In ACD and ACD/IDA animals, i.v. iron administration resulted in iron trapping in liver and splenic macrophages, induction of ferritin expression and increased circulating levels of the iron hormone hepcidin and the inflammatory cytokine interleukin-6, while oral iron supplementation reduced interleukin-6 levels. Thus, oral and i.v. iron resulted in divergent effects on systemic and tissue iron homeostasis and inflammation. Our results indicate that both iron supplements improve Hb in ACD/IDA, but are ineffective in ACD with pronounced inflammation, and that under the latter condition, i.v. iron is trapped in macrophages and may enhance inflammation.
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Affiliation(s)
- Lara Valente De Souza
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck, Austria; Christian Doppler Laboratory for Iron Metabolism and Anemia research, Medical University of Innsbruck
| | - Alexander Hoffmann
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck, Austria; Christian Doppler Laboratory for Iron Metabolism and Anemia research, Medical University of Innsbruck
| | - Christine Fischer
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck
| | - Verena Petzer
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck
| | - Malte Asshoff
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck
| | - Igor Theurl
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck
| | - Piotr Tymoszuk
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck
| | - Markus Seifert
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck, Austria; Christian Doppler Laboratory for Iron Metabolism and Anemia research, Medical University of Innsbruck
| | - Natascha Brigo
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck
| | - Richard Hilbe
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck
| | - Egon Demetz
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck
| | - Laura Von Raffay
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck
| | - Sylvia Berger
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck
| | - Marina Barros-Pinkelnig
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck
| | - Guenter Weiss
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck, Austria; Christian Doppler Laboratory for Iron Metabolism and Anemia research, Medical University of Innsbruck.
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13
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Ashenafi S, Bekele A, Aseffa G, Amogne W, Kassa E, Aderaye G, Worku A, Bergman P, Brighenti S. Anemia Is a Strong Predictor of Wasting, Disease Severity, and Progression, in Clinical Tuberculosis (TB). Nutrients 2022; 14:nu14163318. [PMID: 36014824 PMCID: PMC9413151 DOI: 10.3390/nu14163318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022] Open
Abstract
A typical trait of chronic tuberculosis (TB) is substantial weight loss that concurs with a drop in blood hemoglobin (Hb) levels, causing anemia. In this observational study, we explored Hb levels in 345 pulmonary TB patients. They were divided into anemic or non-anemic groups which related to clinical symptoms, anthropometric measurements, and immune status. Data was obtained in a randomized controlled trial that we previously conducted using nutritional supplementation of TB patients in Ethiopia. A post hoc analysis demonstrated that anemic patients have a higher composite clinical TB score at baseline than non-anemic patients. Consequently, Hb values were significantly lower in underweight patients with moderate to severe disease and/or cavitary TB compared to normal weight patients with mild disease or non-cavitary TB. Anemia was associated with a low body mass index (BMI), low mid-upper arm circumference (MUAC), lower peripheral CD4 and CD8 T cells counts and IFN-γ levels, and a higher erythrocyte sedimentation rate (ESR). Chronic inflammation and TB disease progression appeared to be driven by elevated systemic levels of pro-inflammatory IL-6 in anemic patients. Multivariable modeling confirmed that a low Hb and a low BMI were key variables related to an unfavorable TB disease status. Although Hb levels increased with successful chemotherapy, anemic TB patients maintained a slower clinical recovery compared to non-anemic patients during the intensive phase treatment (two months). In conclusion, anemia is a strong predictor of wasting, disease severity, inflammation, and slower recovery in patients with pulmonary TB.
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Affiliation(s)
- Senait Ashenafi
- Department of Pathology, School of Medicine, College of Health Sciences, Tikur Anbessa Specialized Hospital and Addis Ababa University, Addis Ababa 70710, Ethiopia
- Center for Infectious Medicine (CIM), Department of Medicine Huddinge, ANA Futura, Karolinska Institutet, 141 52 Huddinge, Sweden
| | - Amsalu Bekele
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Tikur Anbessa Specialized Hospital and Addis Ababa University, Addis Ababa 70710, Ethiopia
| | - Getachew Aseffa
- Department of Radiology, School of Medicine, College of Health Sciences, Tikur Anbessa Specialized Hospital and Addis Ababa University, Addis Ababa 70710, Ethiopia
| | - Wondwossen Amogne
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Tikur Anbessa Specialized Hospital and Addis Ababa University, Addis Ababa 70710, Ethiopia
| | - Endale Kassa
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Tikur Anbessa Specialized Hospital and Addis Ababa University, Addis Ababa 70710, Ethiopia
| | - Getachew Aderaye
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Tikur Anbessa Specialized Hospital and Addis Ababa University, Addis Ababa 70710, Ethiopia
| | - Alemayehu Worku
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa 70710, Ethiopia
| | - Peter Bergman
- Clinical Microbiology, Department of Laboratory Medicine (Labmed), ANA Futura, Karolinska Institutet, 141 52 Huddinge, Sweden
- Infectious Disease Clinic, Karolinska University Hospital, 141 86 Stockholm, Sweden
| | - Susanna Brighenti
- Center for Infectious Medicine (CIM), Department of Medicine Huddinge, ANA Futura, Karolinska Institutet, 141 52 Huddinge, Sweden
- Correspondence: ; Tel.: +46-8-524 83773
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14
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Dasaradhan T, Koneti J, Kalluru R, Gadde S, Cherukuri SP, Chikatimalla R. Tuberculosis-Associated Anemia: A Narrative Review. Cureus 2022; 14:e27746. [PMID: 36106202 PMCID: PMC9447415 DOI: 10.7759/cureus.27746] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2022] [Indexed: 11/25/2022] Open
Abstract
Tuberculosis (TB) is an airborne illness that induces systemic inflammation. It often affects the lungs causing cough, fever, and chest pain. A commonly associated comorbid condition in TB is anemia. This review article has summarized various studies with an aim to gain a better understanding of pathogenesis and the role of cytokines that contribute to the development of anemia in TB. The study has gathered risk factors that enhance the likelihood of TB patients acquiring anemia. It has reviewed therapeutic modalities such as antitubercular therapy and iron therapy in an attempt to find which of them are effective in reducing the severity of anemia. This review article has also emphasized the importance of measuring hepcidin and ferritin and has touched upon the investigations that can be easily implemented.
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15
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Hong J, Lai J, Chen X, Yan Y, Hong Y, Ke H, Zheng J. The effects of hypoxia-inducible factors-1α and -2α and erythroferrone on hepcidin in patients with chronic kidney disease stages 3–5 and renal anemia. EUR J INFLAMM 2022. [DOI: 10.1177/1721727x221103468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study aimed to investigate the effects of hypoxia-inducible factor-1α (HIF-1α), hypoxia-inducible factor-2α (HIF-2α), and erythroferrone (ERFE) on hepcidin in patients with chronic kidney disease (CKD) stages 3–5 and renal anemia. Methods A total of 90 patients with CKD stages 3–5 and renal anemia were selected for the study at the Nephrology Department of Fujian Provincial People’s Hospital and divided into three groups, according to CKD stage, while another 30 healthy subjects who underwent a physical examination at the hospital during the same period were selected as the normal group. The serum levels of hepcidin, HIF-1α, HIF-2α, ERFE, and furin were measured using an avidin biotin peroxidase complex enzyme-linked immunosorbent assay to compare the differences between the groups in the related indicators. Results ① Serum HIF-2α, HIF-1α, ERFE, and furin levels increased gradually in the patients with CKD stages 3–5 ( p < 0.05, p < 0.01). ②Simple correlation analysis:Serum hepcidin was positively correlated with HIF-2α, ERFE, and HIF-1α in the CKD patients ( p < 0.01). ③Serum hepcidin was positively correlated with HIF-2α, HIF-1α, and ERFE in the CKD patients injected with erythropoietin (EPO) ( p < 0.01), while serum hepcidin was positively correlated with HIF-2α and HIF-1α ( p < 0.01) in the patients not injected with EPO. ④ Multivariate linear regression analysis showed that HIF-1α, (β = 4.36, p < 0.01), serum ferritin(SF) (β = 0.13, p < 0.01), and HIF-2α (β = 0.66, p < 0.01) were significantly correlated with hepcidin. Conclusion HIF-1α, HIF-2α, and SF are factors which have an effect on hepcidin in patients with CKD stages 3–5 and renal anemia. The increase of HIF-1α, HIF-2α, and ERFE does not seem to inhibit the increase of hepcidin.
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Affiliation(s)
- Jianghuai Hong
- Department of Nephrology, The Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jingjing Lai
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiaoying Chen
- Department of Nephrology, The Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yan Yan
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yanyan Hong
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Hailun Ke
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jing Zheng
- Department of Nephrology, The Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
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16
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Correnti M, Gammella E, Cairo G, Recalcati S. Iron Mining for Erythropoiesis. Int J Mol Sci 2022; 23:ijms23105341. [PMID: 35628152 PMCID: PMC9140467 DOI: 10.3390/ijms23105341] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 01/27/2023] Open
Abstract
Iron is necessary for essential processes in every cell of the body, but the erythropoietic compartment is a privileged iron consumer. In fact, as a necessary component of hemoglobin and myoglobin, iron assures oxygen distribution; therefore, a considerable amount of iron is required daily for hemoglobin synthesis and erythroid cell proliferation. Therefore, a tight link exists between iron metabolism and erythropoiesis. The liver-derived hormone hepcidin, which controls iron homeostasis via its interaction with the iron exporter ferroportin, coordinates erythropoietic activity and iron homeostasis. When erythropoiesis is enhanced, iron availability to the erythron is mainly ensured by inhibiting hepcidin expression, thereby increasing ferroportin-mediated iron export from both duodenal absorptive cells and reticuloendothelial cells that process old and/or damaged red blood cells. Erythroferrone, a factor produced and secreted by erythroid precursors in response to erythropoietin, has been identified and characterized as a suppressor of hepcidin synthesis to allow iron mobilization and facilitate erythropoiesis.
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17
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Kubik E, Moynier F, Paquet M, Siebert J. Iron Isotopic Composition of Biological Standards Relevant to Medical and Biological Applications. Front Med (Lausanne) 2021; 8:696367. [PMID: 34746169 PMCID: PMC8563829 DOI: 10.3389/fmed.2021.696367] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 09/13/2021] [Indexed: 01/01/2023] Open
Abstract
Iron isotopes are fractionated by multiple biological processes, which offers a novel opportunity to study iron homeostasis. The determination of Fe isotope composition in biological samples necessitates certified biological reference materials with known Fe isotopic signature in order to properly assess external reproducibility and data quality between laboratories. We report the most comprehensive study on the Fe isotopic composition for widely available international biological reference materials. They consist of different terrestrial and marine animal organs (bovine, porcine, tuna, and mussel) as well as apple leaves and human hair (ERC-CE464, NIST1515, ERM-DB001, ERM-BB186, ERM-BB184, ERM-CE196, BCR668, ERM-BB185, ERM-BB124). Previously measured Fe isotopic compositions were available for only two of these reference materials (ERC-CE464 tuna fish and ERM-BB186 pig kidney) and these literature data are in excellent agreement with our data. The Fe isotopic ratios are reported as the permil deviation of the 56Fe/54Fe ratio from the IRMM-014 standard. All reference materials present δ56Fe ranging from −2.27 to −0.35%0. Combined with existing data, our results suggest that animal models could provide useful analogues of the human body regarding the metabolic pathways affecting Fe isotopes, with many potential applications to medicine.
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Affiliation(s)
- Edith Kubik
- Université de Paris, Institut de Physique du Globe de Paris, CNRS, Paris, France
| | - Frédéric Moynier
- Université de Paris, Institut de Physique du Globe de Paris, CNRS, Paris, France.,Institut Universitaire de France, Paris, France
| | - Marine Paquet
- Université de Paris, Institut de Physique du Globe de Paris, CNRS, Paris, France
| | - Julien Siebert
- Université de Paris, Institut de Physique du Globe de Paris, CNRS, Paris, France.,Institut Universitaire de France, Paris, France
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18
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TB or not TB? Soft pity opens the iron gates. Blood 2021; 138:1285-1287. [PMID: 34647984 DOI: 10.1182/blood.2021012003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 04/14/2021] [Indexed: 11/20/2022] Open
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