Sucrosomial Iron®: A New Highly Bioavaible Oral Iron Supplement

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4561-4561 ◽  
Author(s):  
Germano Tarantino ◽  
Elisa Brilli ◽  
Ylenia Zambito ◽  
Giulio Giordano ◽  
Francesco Equitani

Abstract Introduction: Iron deficiency is one of the most widespread nutritional deficiencies. Globally two billion people are suffering from iron- deficiency anemia (Hermida et al., 2010). Oral therapy for iron deficiency is mainly based on immediate release formulations of ferrous iron. However, modified formulations have been marketed to reduce gastrointestinal side effects and to prevent iron instability in the gastrointestinal tract. Overcoming biological barriers, including the gastrointestinal epithelial barriers, is a great challenge for pharmaceutical research and thus there is a need for new absorption enhancers with more favorable profile. Sucrose esters are widely used in the food industry, and there are reports on their potential use in pharmaceutical formulations as excipients (Szuts A et al., 2008). In vitro methods using cell cultures have been proposed to assess iron bioavailability as an alternative to in vivo methods. Caco-2 cells have shown numerous morphological and biochemical characteristics of enterocytes and have been successfully used to study iron absorption (Garcia et al., 1996; Jovani et al., 2001). Caco-2 monolayers formed a good barrier as reflected by high transepithelial resistance and positive immunostaining for junctional proteins. Sucrose esters in nontoxic concentrations significantly reduced resistance and impedance, and increased permeability of some components in Caco-2 monolayers. Recent data indicate that sucrose esters can enhance drug permeability through both the transcellular and paracellular routes (Kiss et al., 2014). Aim: The strong correlation between the published human absorption data and the iron uptake by Caco-2 cells makes them an ideal in vitro model to study iron bioavailability (Au and Reddy, 2000). For this, in the present study, we compared the bioavailability of innovative Oral Iron formulation based on Sucrosomial Iron¨ (Sideral¨) with three different Iron formulations (Figure 1). Materials and Methods: Sucrosomial Iron, preparation of ferric pyrophosphate convered by a phospholipids plus sucrose esters of fatty acids matrix; Lipofer¨, a water-dispersible micronised iron; Sunactive¨ ferric pyrophosphate, lecithin and emulsifiers. Results: The data showed that Sucrosomial Iron¨ (Sideral¨), is significantly more bioavaible than microencapsulated Ferric pyrophosphate ingredients, Lipofer¨ and Sunactive¨ and Ferrous Sulfate in Caco-2 cell model (Figure 1). Bibliography Au, A. P., Reddy, M. B. (2000). Caco-2 cells can be used to assess human iron bioavailability from a semipurified meal. J Nutr 130:1329-1334. Garcia et al. (1996). The Caco-2 cell culture system can be used as a model to study food iron availability. J Nutr 126:251-258. Hermida et al., Preparation and characterization of iron-containing liposomes: their effect on soluble iron uptake by Caco-2 cells Journal of Liposome Research, 2010, 1-10, Jovani et al. (2001) Calcium, iron, and zinc uptake from digests of infant formulas by Caco-2 cells. J Agric Food Chem 49:3480-3485. Kiss et al., (2014) Sucrose esters increase drug penetration, but do not inhibit p-glycoprotein in caco-2 intestinal epithelial cells J Pharm Sci. Oct;103(10):3107-19. Szuts A et al. (2008) Study of the effects of drugs on the structures of sucrose esters and the effects of solid-state interactions on drug release J Pharm Biomed Anal. 48: Figure 1. the graph shows the Ferritin levels of Caco-2 cells after iron formulations treatment. Sucrosomial Iron treated cells display significant increase of Ferritin synthesis compared to Lipofer and SunActive treated cells. Figure 1. the graph shows the Ferritin levels of Caco-2 cells after iron formulations treatment. Sucrosomial Iron treated cells display significant increase of Ferritin synthesis compared to Lipofer and SunActive treated cells. Disclosures Tarantino: Pharmanutra s.p.a.: Employment. Brilli:Pharmanutra s.p.a.: Employment.

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4891-4891
Author(s):  
Ajaz Bulbul ◽  
Emilio Araujo Mino ◽  
Vyas Dake ◽  
Adriana Bautista ◽  
Lisa Lentkowski ◽  
...  

Abstract Introduction Practice guidelines for Iron deficiency anemia (IDA) suggest taking ferrous iron in divided doses. Recent studies suggest that split daily dosing may increase serum hepcidin which reduces iron bioavailability. Adherence to oral iron supplementation (OIS) can also be a barrier to treatment. In practice iron dosing varies significantly with unclear evidence of benefit from a particular dosing regimen. Methods This is a retrospective study evaluating outcomes of different schedules of OIS in 146 patients with IDA (Hb <12.2 and/or ferritin of < 30 ng/mL) treated between June 2017-June 2018. Patients with multifactorial anemia were excluded. Descriptive statistics and Chi-square were used for analysis. Results The mean age was 66.8 ± 1.3; women constituted 70% of the cohort (M/F 44/102). Mean Hb was 11.59 ± 0.12; Median ferritin was 22 ng/ml (IQR 10-63). Four different schedules of OIS evaluated were every other day (QOD) 60% (88/146), daily (QD)15% (22/146), twice daily (BID) 12%(18/146) and three times a day (TID) 12% (18/146). After one month of OIS a mean increase in Hb was (0.44 mg/dl + 0.04). GI toxicity occurred in 10.2% (15/146), therapy discontinuation in 4.8% (7/146) and IV iron was required in 9.6 % (14/146) of all cases. Among patients without GI toxicity 65% (85/131) were on QOD vs other schedules (X² 11.7 p=0.008), 63% (87/139) were compliant on QOD (X² 9.05 p=0.029). Salvage IV iron was not required in 64% (84/132) of QOD patients (X² 22.7 p=<0.001). One month post therapy, patients on QOD schedule had ≥1 g/dl improvement in 38% (10/26) (X² 9.18 p= 0.027) and increase of >0.5g/dl in 68% (69/102) of cases (X² 9.63 p= 0.022). Conclusions Alternate day iron dosing may optimize iron absorption and is possibly a better tolerated regimen. Larger prospective studies need to confirm these findings Disclosures No relevant conflicts of interest to declare.


Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2776
Author(s):  
Magalie Sabatier ◽  
Andreas Rytz ◽  
Joeska Husny ◽  
Stéphane Dubascoux ◽  
Marine Nicolas ◽  
...  

A new iron–casein complex (ICC) has been developed for iron (Fe) fortification of dairy matrices. The objective was to assess the impact of ascorbic acid (AA) on its in vitro bioavailability in comparison with ferrous sulfate (FeSO4) and ferric pyrophosphate (FePP). A simulated digestion coupled with the Caco-2 cell culture model was used in parallel with solubility and dissociation tests. Under diluted acidic conditions, the ICC was as soluble as FeSO4, but only part of the iron was found to dissociate from the caseins, indicating that the ICC was an iron chelate. The Caco-2 cell results in milk showed that the addition of AA (2:1 molar ratio) enhanced iron uptake from the ICCs and FeSO4 to a similar level (p = 0.582; p = 0.852) and to a significantly higher level than that from FePP (p < 0.01). This translated into a relative in vitro bioavailability to FeSO4 of 36% for FePP and 114 and 104% for the two ICCs. Similar results were obtained from water. Increasing the AA to iron molar ratio (4:1 molar ratio) had no additional effect on the ICCs and FePP. However, ICC absorption remained similar to that from FeSO4 (p = 0.666; p = 0.113), and was still significantly higher than that from FePP (p < 0.003). Therefore, even though iron from ICC does not fully dissociate under gastric digestion, iron uptake suggested that ICCs are absorbed to a similar amount as FeSO4 in the presence of AA and thus provide an excellent source of iron.


2020 ◽  
Vol 12 (3) ◽  
pp. 151-155
Author(s):  
Fauzan Amin ◽  
◽  
Micha Mahardika ◽  
Dianastya Yuniarti ◽  
◽  
...  

Iron deficiency anemia is caused by the low intake of iron from foods. The purpose of this research was to make fortified tempeh using sesame seed with a high potential utility as iron fortificant. The iron bioavailability was carried out in vitro by simulating human digestion for raw and cooked tempeh. The iron fortificant added were 0, 10, 20, 25, 30 ,40 and 50% of sesame seed to substitute 100 grams of soybeans. The results of this study showed that the highest Fe content of 0.4539 mg was obtained by replacing 50% soybean with sesame seed. But after cooking, there is a decrease in boiled for 10, 20, 30,40,50% variants and increase in fried for 0, 10, 25, 30% variants.


1963 ◽  
Vol 204 (1) ◽  
pp. 171-175 ◽  
Author(s):  
W. S. Ruliffson ◽  
J. M. Hopping

The effects in rats, of age, iron-deficiency anemia, and ascorbic acid, citrate, fluoride, and ethylenediaminetetraacetate (EDTA) on enteric radioiron transport were studied in vitro by an everted gut-sac technique. Sacs from young animals transported more than those from older ones. Proximal jejunal sacs from anemic animals transported more than similar sacs from nonanemic rats, but the reverse effect appeared in sacs formed from proximal duodenum. When added to media containing ascorbic acid or citrate, fluoride depressed transport as did anaerobic incubation in the presence of ascorbic acid. Anaerobic incubation in the presence of EDTA appeared to permit elevated transport. Ascorbic acid, citrate, and EDTA all enhanced the level of Fe59 appearing in serosal media. These results appear to agree with previously established in vivo phenomena and tend to validate the in vitro method as one of promise for further studies of factors affecting iron absorption and of the mechanism of iron absorption.


1993 ◽  
Vol 33 (6) ◽  
pp. 661-661
Author(s):  
Helena U Suzuki ◽  
Mauro B Morais ◽  
Jose N Corral ◽  
Ulisses Fagundes-Neto ◽  
Nelson L Machado

PEDIATRICS ◽  
1963 ◽  
Vol 31 (6) ◽  
pp. 1041-1044
Author(s):  
LOUIS K DIAMOND ◽  
J. LAWRENCE NAIMAN ◽  
DONALD M. ALLEN ◽  
FRANK A. OSKI,

Experience with a new oral iron-carbohydrate complex (Jefron) in the treatment of iron-deficiency anemia shows that the therapeutic results are inferior to those obtainable with ferrous sulfate. Many children showed no response after months of treatment with this drug and when subsequently placed on ferrous sulfate therapy showed a rapid rise in hemoglobin to normal levels. Preliminary studies suggest that poor gastrointestinal absorption may be a factor in the inadequate therapeutic effects.


Author(s):  
Adam K. Lewkowitz ◽  
Molly J. Stout ◽  
Emily Cooke ◽  
Seon C. Deoni ◽  
Viren D'Sa ◽  
...  

Objective Iron-deficiency anemia (IDA) can have serious consequences for mothers and babies. Iron supplementation is recommended, but the administration route is controversial. We sought to conduct a randomized controlled trial (RCT) testing the effectiveness and safety of intravenous (IV) iron compared with oral iron on perinatal outcomes in pregnant women with IDA. Study Design This open-label RCT randomized patients with IDA (hemoglobin [hgb] <10 g/dL and ferritin <30 ng/mL) at 24 to 34 weeks' to oral iron or single 1,000-mg dose of IV low-molecular weight iron dextran over one hour. The primary outcome was maternal anemia at delivery (hgb < 11 g/dL). Secondary outcomes were mild/moderate or severe adverse reactions, maternal hgb and ferritin at delivery, blood transfusion, gestational age at delivery, birth weight, neonatal hgb and ferritin, and composite neonatal morbidity. Analysis was as per protocol. Results The trial was stopped early for logistical reasons, and the data analyzed as preliminary data to inform a larger, potentially externally funded, definitive trial. Of 55 patients approached, 38 consented. Of these, 15 were withdrawn: 5 received IV iron from their primary obstetrician after being randomized to oral iron and 10 declined to receive IV iron. Of the remaining 23 patients, who were included in the analytic population, 13 received oral iron and 10 received IV iron. The rate of maternal anemia at delivery (hgb < 11 g/dL) was high overall but significantly reduced with IV iron (40 vs. 85%, p = 0.039). Rates of maternal hgb < 10 g/dL were significantly lower in the IV iron group (10 vs. 54%, p = 0.029). There were no severe adverse reactions and similar rates of mild/moderate reactions between groups. Conclusion IV iron reduces rates of anemia at the time of admission for delivery, supporting a larger RCT comparing IV versus oral iron for the treatment of IDA of pregnancy powered for definitive clinical outcomes. However, issues uncovered in this RCT suggest that patient, clinician, and systems-level barriers associated with different IDA treatment modalities must be considered prior to conducting a larger RCT. This study is registered with clinicaltrials.gov with identifier no.: NCT03438227. Key Points


Sign in / Sign up

Export Citation Format

Share Document