scholarly journals Long-term Effect of Intravenous Iron Carboxymaltose Treatment on Oxidative Stress in Women with Iron Deficiency Anemia

2021 ◽  
pp. 3-10
Author(s):  
Gökhan Pektaş ◽  
İsmail Kırlı
Keyword(s):  
Oxidative Stress ◽  
Nitric Oxide ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Catalase Activity ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
Healthy Controls ◽  
Iron Treatment ◽  
Oxidant Status

Objective: This study aims to clarify the effects of intravenous iron supplementation on biomarkers for oxidative stress in women with iron deficiency anemia. Methods: This is a cross-sectional review of 40 healthy women and 40 women who underwent intravenous iron treatment due to anemia. Biochemical markers for oxidative stress were determined for both healthy controls and anemic patients. These markers were also evaluated at hour 1 and day 30 of intravenous iron treatment. Results: The patients with anemia had significantly higher catalase activity and total oxidant status (TOS) but significantly lower nitrate and total anti-oxidant status (TAS) than the healthy controls (p=0.0245, p<0.0001, p=0.0437 and p<0.0001 respectively). At hour 1 of intravenous iron treatment, nitrate, nitrite, nitric oxide, total thiol and TAS values were significantly lower and TOS values were significantly higher than those before the administration of treatment (p=0.0322, p=0.0003, p=0.0005, p<0.0001, p<0.0001 and p=0.004). At day 30 of intravenous iron treatment, catalase activity, nitrate, total thiol and TOS values were significantly lower than those before the administration of treatment (p=0.0332, p=0.0015, p=0.0391 and p<0.0001 respectively) and at hour 1 of treatment (p=0.0498, p<0.0001, p=0.0004 and p<0.0001 respectively). At day 30 of intravenous iron treatment, nitric oxide and TAS values were significantly higher than those before the administration of treatment (p=0.0480 and p=0.001 respectively) and at hour 1 of treatment (p<0.0001 for both). Conclusion: Intravenous iron replacement prompts oxidative stress at hour 1 of infusion in adults with anemia but this increase resolves partially in the following 30 days.

Glutathionyl Hemoglobin Has Potential as a Biomarker of Iron Deficiency Anemia

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3210-3210
Author(s):  
Arun S. Shet ◽  
Sneha Pinto ◽  
Gopa Mitra ◽  
Pooja Subramaniam ◽  
Amit Mandal
Keyword(s):  
Oxidative Stress ◽  
Mass Spectrometry ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Serum Ferritin ◽  
Conflicts Of Interest ◽  
Deficiency Anemia ◽  
Healthy Controls ◽  
Major Health Problem ◽  
Oxidative Modifications

Abstract Abstract 3210 Introduction: Iron deficiency anemia (IDA) is a major health problem worldwide. Although a clinical diagnosis is relatively simple, specific laboratory markers of IDA are lacking especially in the setting of inflammation. Ferritin, the current standard to define IDA is an acute phase protein that is non-specifically elevated during inflammation. Serum transferrin receptor level measurements although available are not yet standardized as a clinical tool. Serum hepcidin is a recently developed novel marker that is currently neither available nor standardized sufficiently. Furthermore, such assays require instrumentation, technical sophistication, and are expensive. Objectives: We sought to identify novel markers of IDA using mass spectrometry based proteomics. Identifying such markers could yield targets that once validated could serve cost effective point of care assays to detect iron deficiency anemia. Since there is evidence for oxidative damage mediated by reactive oxygen species in IDA, as a first step, we characterized and quantified posttranslational oxidative modifications of hemoglobin and tested their utility as biomarkers. Patients and Methods: We prospectively enrolled patients with IDA (defined as ferritin <12ng/ml in the presence of normal CRP and/or a bone marrow aspirate with “0” iron stores) and healthy controls (n = 23 and 15 respectively). Patients with diabetes, cardiovascular disease, renal disease, cerebrovascular disease and liver disease were excluded as these are conditions associated with preexisting oxidant stress. Erythrocytes from the blood of IDA patients and controls were isolated by centrifugation, washed in 0.9% saline, and lysed in distilled water to yield intracellular hemoglobin. Hemoglobin was then either studied further as an intact molecule or after digestion with trypsin. We used matrix assisted laser desorption ionization (MALDI - TOF) mass spectrometry to identify oxidative modifications of tryptic digested hemoglobin. We used electro spray ionization (ESI) mass spectrometry to identify and semiquantitate oxidative hemoglobin modifications by methods previously established and published by others and ourselves. Results: Using a combination of mass spectrometric methods, we identified 4 oxidative modifications of hemoglobin in patients with IDA and healthy controls (Table 1). Interestingly, a non enzymatic posttranslational modification of hemoglobin, glutathionyl hemoglobin, was found to be significantly increased in IDA patients compared with healthy controls (Glutathionyl hemoglobin % of beta chain; mean ± SD 0.169 ± 0.096 vs 0.077 ± 0.037; p = 0.001). Markers of oxidative stress (reduced RBC glutathione) were lower in IDA compared to healthy controls but the difference was not significant (mean ± SD 0.92 ± 0.53 vs 1.08 ± 0.52 mmol/L; p = 0.54). Glutathionyl hemoglobin levels correlated inversely with serum ferritin (Spearman rho -0.485; p < 0.05). Conclusions: Using two distinct proteomic methods, we identified oxidative posttranslational modifications of hemoglobin in IDA and healthy controls. Glutathionyl hemoglobin, an established marker of oxidative stress was elevated in patients with IDA and correlated inversely with serum ferritin. Overall, these findings suggest that glutathionyl hemoglobin has potential as a biomarker of IDA. Disclosures: No relevant conflicts of interest to declare.

Oxidative stress, HDL functionality and effects of intravenous iron administration in women with iron deficiency anemia

2017 ◽  
Vol 36 (2) ◽  
pp. 552-558 ◽  
Author(s):  
Tomás Meroño ◽  
Carolane Dauteuille ◽  
Walter Tetzlaff ◽  
Maximiliano Martín ◽  
Eliana Botta ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
Iron Administration ◽  
Hdl Functionality

scholarly journals Treatment of Iron Deficiency Anemia in Orthopedic Surgery with Intravenous Iron: Efficacy and Limits

2007 ◽  
Vol 107 (6) ◽  
pp. 923-927 ◽  
Author(s):  
Oliver M. Theusinger ◽  
Pierre-François Leyvraz ◽  
Urs Schanz ◽  
Burkhardt Seifert ◽  
Donat R. Spahn
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Orthopedic Surgery ◽  
Iron Status ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
Bonferroni Correction ◽  
Maximum Increase ◽  
Endogenous Erythropoietin ◽  
Iron Treatment

Background Preoperative anemia is frequent in patients undergoing orthopedic surgery. The purpose of this study was to assess the preoperative increase of hemoglobin in iron deficiency anemia patients treated with intravenous iron. Methods After obtaining written informed consent, 20 patients with iron deficiency anemia received 900 mg intravenous iron sucrose over 10 days starting 4 weeks before surgery. Changes of hemoglobin and iron status were measured over 4 weeks and at discharge. In the last 11 patients, endogenous erythropoietin was also measured. Data were analyzed using the Friedman test followed by pairwise Wilcoxon signed rank tests with Bonferroni correction. Results Hemoglobin increased significantly (P &lt; 0.0001) after intravenous iron treatment. Overall, the mean maximum increase was 1.0 +/- 0.6 g/dl (range, 0.2-2.2 g/dl). Ferritin increased from 78 +/- 70 to 428 +/- 191 microg/l (P = 0.0001), ferritin index decreased from 2.7 +/- 2.4 to 1.5 +/- 1.0 (P = 0.0001), and soluble transferrin receptor decreased from 4.1 +/- 2.3 mg/l to 3.7 +/- 2.3 mg/l (P = 0.049), whereas transferrin saturation (20.5 +/- 9.0 to 22.9 +/- 9.0%) and serum iron (13.3 +/- 4.6 to 13.1 +/- 4.5 microm) did not change significantly after intravenous iron treatment. Endogenous erythropoietin decreased from 261 +/- 130 pg/ml to 190 +/- 49 pg/ml 2 weeks after intravenous iron treatment (P = 0.050, not significant after Bonferroni correction). No adverse events related to intravenous iron were observed. The maximum increase of hemoglobin was observed 2 weeks after the start of intravenous iron treatment, indicating that administration of intravenous iron 2-3 weeks before surgery may be optimal. Conclusion Treatment with intravenous iron allows correcting iron deficiency anemia before elective surgery.

scholarly journals Comparison of ferric carboxymaltose versus Iron Sucrose for treatment of iron deficiency anemia in pregnancy.

2021 ◽  
Vol 28 (04) ◽  
pp. 481-484
Author(s):  
Hira Jamal ◽  
Humaira Zafar ◽  
Mubashra Naz ◽  
Umber Fatima ◽  
Anees Fatima
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Intravenous Iron ◽  
Iron Sucrose ◽  
Deficiency Anemia ◽  
Ferric Carboxymaltose ◽  
P Value ◽  
Iron Treatment ◽  
Group A ◽  
Group B

Objective: To compare the mean increase in hemoglobin level with ferric carboxymaltose injection and iron sucrose injection for the management of the pregnant females presenting with iron deficiency anemia. Study Design: Randomized Controlled Trial. Settings: Department of Obstetrics and Gynecology Madina Teaching Hospital affiliated with University medical and Dental College Faisalabad. Period: July 2019 to December 2019. Material & Method: A total number of 100 patients presented in OPD satisfying the selection criteria were enrolled in the study after permission from ethical committee. On enrollment, a detailed clinical history which include previous iron treatment including and chronic medical disorders was taken. Clinical examination was done. Investigations for anemia include hemoglobin, reticulocyte count, peripheral film and red cell indices, serum ferritin level and Hb electrophoresis if indicated. The patients were randomly divided in two groups. In group A, females were given ferric carboxymaltose and in group B, females were given iron sucrose. After calculating the total iron deficit, patients in group A were given intravenous FCM. Patients in group B were given IS. Follow up of the patient was done after 3 weeks of intravenous iron treatment. The baseline Hb and values after 3 weeks of intravenous iron treatment were compared between the FCM and IS groups and increase in Hb level calculated as mean and SD. Both groups were analyzed for rise in Hb level by using independent sample t test. P value < 0.05 was taken as significant. Results: A total 100 pregnant female were found eligible for study, and were randomized into two groups of 50 each. Mean increase in hemoglobin level with ferric carboxymaltose and iron sucrose was evaluated, it shows that baseline Hb was 8.84±0.68 in Group A and 8.78 ±0.76 in Group B, P value was 0.67, after treatment Hb was 12.02±0.89 in Group A and 10.92 ±0.99 in Group B. Mean increase was 3.18 ±0.60 in Group A and 2.14±0.81 in Group B. P value was 0.001. Conclusion: Ferric carboxymaltose significantly increase Hb level and restores the iron stores as compare to iron sucreose. FCM is safe and effective intravenous treatment for iron deficiency anemia in pregnancy. FCM has the advantages of single large dose administration and fewer hospital visit. FCM is most suitable drug for the treatment of patients with IDA who required quick replenishment of iron stores.

The Effects Of Oral Iron Treatment On Reactive Oxygen Radicals, Protective Enzymes and Lipid Peroxidation In Women With Iron Deficiency Anemia

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4670-4670
Author(s):  
Gurhan Kadikoylu ◽  
Arzu Ozkan ◽  
Cigdem Yenisey ◽  
Irfan Yavasoglu ◽  
Zahit Bolaman
Keyword(s):  
Oxidative Stress ◽  
Lipid Peroxidation ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Oxygen Radicals ◽  
Reactive Oxygen ◽  
Deficiency Anemia ◽  
Control Group ◽  
Iron Treatment ◽  
Protective Enzymes

Iron deficiency anemia (IDA) is the commonest of deficiency disease in the world. In IDA, hemoglobin synthesis is impaired, nonetheless the production of iron (Fe2) containing proteins such as cytochrom, myoglobin, catalase (CAT), and peroxidase is affected. While oxidative stress can play an important role on the development of IDA, lipid peroxidation may be induced. The aim of the study is to investigate the effects of oral iron treatment on reactive oxygen radicals (ROR), protective enzymes from ROR, and lipid peroxidation in women with IDA. This prospective Phase-IV study was approved by ethical committees of university and the Ministry of Health. Sixty-seven women (mean age 34±11 years) with IDA were enrolled to the study. Inclusion criteria were hemoglobin level < 11 g/dl, serum ferritin level < 16 ng/ml, and iron saturation <15%. Twenty-seven helathy women (mean age 27±7 years) were accepted as control group. Exclusion criteria of control group were anemia, acute and chronic infection, acute and chronic bleeding, pregnancy, malignancy, chronic inflammatory, and renal diseases. In both group, whole blood counts, hydrogen peroxide (H202) as ROR, glutathione (GSH), superoxide dismutase, glutathione peroxidase, glutathione reductase, CAT for protective enzymes from ROR, and malondialdehyde (MDA) for lipid peroxidation were evaluated. Ferrous fumarate 200 mg/day were given to the patients for 4 weeks. At the end of 4 weeks, all parameters were repeated. All results were compared with SPSS 15.0 using independent and paired t-tests. P values <0.05 were accepted as significant. In women with IDA, the levels of GSH (p<0.001), H202 (p<0.001), and MDA (p<0.05) were significantly higher than controls, but other parameters were not different in both groups (p>0.05). At the end of treatment, GSH and H202 levels significantly decreased (p<0.001 for both), but other parameters did not changed (p>0.05). In women with IDA, while H202 increased, lipid peroxidation was induced. Compensation of oxidative stress were ensured by GSH. Iron treatment reduced oxidative stress, but it did not affect lipid peroxidation and protective enzymes from ROR. Disclosures: No relevant conflicts of interest to declare.

scholarly journals P350 SAFIIR: Study of Anemia Following Intravenous Iron Repletion

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S371-S372
Author(s):  
L C Rioux ◽  
E J Bernard ◽  
M Bourgault ◽  
P Mondragon ◽  
V Rioux
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Transferrin Saturation ◽  
Real Life ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
The Real ◽  
Iron Treatment ◽  
Life Impact ◽  
Iv Iron

Abstract Background The main objective of this study was to assess the prevalence of anemia and the secondary objectives aimed to evaluate the real-life impact of intravenous iron therapy on anemia correction in patients living with Inflammatory Bowel Disease (IBD). Methods We performed a retrospective cohort study of adult patients (18 to 80 years old) with a Crohn’s Disease or Ulcerative Colitis diagnosis who were followed at our clinic between January 2018 and March 2020. Clinical data were obtained from the patients’ electronic medical records. Iron-deficiency anemia was defined as hemoglobin (Hb) &lt; 12,0 g/dL and/or transferrin saturation (TSAT)&lt; 20 % and/or low serum iron (≤ 10 μmol/L). Intravenous (IV) iron treatment was defined as at least one infusion of iron isomaltoside, iron sucrose, or sodium ferric gluconate. The secondary analyses were performed in terms of IV iron treatments. Results Of the cohort of 556 IBD patients, 223 (40.1%) had an anemia diagnosis. Among the latter, 39 patients received an intravenous iron treatment and had laboratory results in the 8 weeks preceding and in the 8 weeks following the treatment. Table 1 shows the response to intravenous iron treatment in patients with baseline Hb &lt; 12,0 g/dL (n=28 patients, 47 IV iron infusions). Table 2 shows the changes in anemia-related laboratory values in the 8 weeks preceding and in the 8 weeks following intravenous iron treatment. Conclusion This was the first study to evaluate the prevalence of iron-deficiency anemia and the real-life impact of intravenous iron treatment among patients living with IBD in Quebec, Canada. The findings will serve as a baseline for subsequent interventions to improve the wellbeing and the quality of life of IBD patients with anemia.

Intravenous iron sucrose complex in the treatment of iron deficiency anemia during pregnancy

1996 ◽  
Vol 69 (2) ◽  
pp. 121-124 ◽  
Author(s):  
Abdul-Kareem Al-Momen ◽  
Abdulaziz Al-Meshari ◽  
Lulu Al-Nuaim ◽  
Abdulaziz Saddique ◽  
Zainab Abotalib ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Intravenous Iron ◽  
Iron Sucrose ◽  
Deficiency Anemia ◽  
Anemia During Pregnancy
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