Iron serum levels and iron homeostasis parameters in patients with nosocomial pneumonia treated with cefiderocol: post hoc analysis of the APEKS-NP study

Critically ill patients often present with low serum iron levels or anemia. We evaluated the impact of iron levels and iron homeostasis on the efficacy and safety of cefiderocol, an iron-chelator siderophore cephalosporin, in patients with nosocomial pneumonia in a post hoc analysis of the randomized, double-blind, Phase 3 APEKS-NP study (NCT03032380). Patients with Gram-negative nosocomial pneumonia received cefiderocol 2 g, 3-h infusion, q8h, or high-dose, extended-infusion meropenem 2 g, 3-h infusion, q8h, for 7–14 days. Efficacy and safety parameters, including specific iron homeostasis parameters (i.e., hepcidin, iron, total iron binding capacity, transferrin saturation), were analyzed according to baseline iron levels. In the cefiderocol and meropenem arms, 79.1% (117/148) and 83.3% (125/150) randomized patients, respectively, had low baseline serum iron levels. Rates of 14-day (12.3% [14/114] vs 11.6% [14/121]) and 28-day all-cause mortality (20.5% [23/112] vs 19.0% [23/121]), clinical cure (63.2% [72/114] vs 67.2% [82/122]), and microbiological eradication (43.6% [41/94] vs 48.1% [51/106]) at test of cure were similar in cefiderocol vs meropenem arms, respectively. In the overall safety population, rates of anemia-related adverse events were similar (cefiderocol arm 18.2% [27/148], meropenem arm 18.7% [28/150]). Changes from baseline to test of cure in hepcidin, iron, total iron binding capacity, and transferrin saturation were similar between treatment arms. Cefiderocol treatment did not affect iron homeostasis, and its efficacy and safety were not influenced by baseline serum iron levels. Clinicaltrials.gov registration: NCT03032380. Date of registration: 26 January 2017.

Prevalence and associated risk factors of iron deficiency without anemia among school adolescents in Mbouda, Western Cameroon

Background: Adolescents are a particularly vulnerable age group to iron deficiency without anemia (IDWA). This study aimed at determining the prevalence and associated risks factors of IDWA among apparently healthy school teenagers in Mbouda, West-Cameroon.Methods: The 778 blood samples were randomly collected from adolescents aged 10-19 years of four schools in Mbouda. Appropriate indicators including haemoglobin and haematocrit, serum iron, ferritin, transferrin, and total iron binding capacity, transferrin saturation were determined using standard methods.Results: The overall prevalence of IDWA was 40.4%. High significant difference in the mean values of serum iron (p≤0.001), serum ferritin (p≤0.001), TIBC (p=0.007), CST (p≤0.001) were observed in participants with IDWA compared to those without IDWA. The sociodemographic risk factors of IDWA in school adolescents were school site (p=0.022; 0.14 (0.90-1.43) and period of menstruation (p=0.015; 1.48 (1.083-2.03). Consumption of roots-tubers [OR: 0.92 (0.48-1.77)] legumes [OR: 2.65 (1.91-3.67)], cereals [OR: 0.90 (0.67-1.22)], increased the risk of IDWA while consumption of vegetables [OR: 0.29 (0.22-0.39)], eggs [OR: 0.66 (0.49-0.90)], and fish-shrimp [OR: 0.172 (0.10-0.295)] decreased the risk of IDWA. Meal consumption frequency had a statistically significant association with IDWA (p≤0.001).Conclusions: This study identified that IDWA was a major public health in adolescents. This study will help in planning and implementation of the policy for prevention of IDWA in adolescents.

Low Serum Iron Status Is Associated With Low Incidence of Coronary Artery Disease In Women

Background: Disorders of iron metabolism has been implicated in cardiovascular disease. However, the association of serum ferritin and coronary artery disease (CAD) remains inconsistent. Here, we investigated the associations of serum iron metabolism with the incidence of CAD, the severity of coronary artery stenosis, metabolic biomarkers, and 1-year restenosis after coronary artery revascularization. Methods: A total of 643 CAD patients and 643 healthy controls were enrolled to assess the associations of serum iron status with the presence of CAD, the severity of CAD, and 1-year rehospitalization after revasculation. Serum iron metabolism and other metabolic markers were measured in all subjects. All statistical analyses were analyzed using SPSS22.0 software and STATA statistical package.Results: Serum level of iron metabolism markers, including serum iron, ferritin, unsaturated transferrin iron binding capacity (UIBC), Total iron binding capacity (TIBC) levels, in CAD groups was significantly higher than the control group (P<0.001). UIBC and TIBC were negatively correlated with ferritin in both sexes. Serum level of iron (OR=0.806, 95% CI (0.687-0.944), UIBC (OR=0.919, 95% CI (0.852-0.992), and TIBC (OR=0.864, 95% CI (0.787-0.95) were found to have a protective role for CAD in women (P<0.05, Table 3). The OR for ferritin was significant in the both sexes (OR=1.029, 95% CI (1.002-1.058) in men, OR=1.02, 95% CI (1.005-1.034) in women, P<0.05). Conclusion: Low Serum level of iron, UIBC, TIBC and ferritin levels were found to have a protective role for CAD in women, but not in men. Elevated serum ferritin is independently and positively associated with CAD in men and women.

Hemodialysis Duration with Levels of Hemoglobin, Hematocrit, Serum Iron and Total Iron Binding Capacity on Chronic Kidney Disease

The correlation of the length of time undergoing hemodialysis with the levels of hemoglobin, hematocrit, serum iron and total iron binding capacity in patients with chronic kidney disease at RSUD Prof. Dr. W. Z. Johannes Kupang. People with chronic kidney disease who are performing Hemodialysis suffer from anemia. Blood loss during the hemodialysis process is affected by frequent blood sampling for laboratory tests. To diagnose the occurrence of iron deficiency, anemia laboratory tests such as complete blood, serum iron (SI), TIBC, transferrin saturation, and serum ferritin can be conducted. The objective of this study is to determine the correlation between the length of undergoing Hemodialysis with the levels of Hemoglobin, Hematocrit, Serum Iron, and Total Iron Binding Capacity (TIBC) in patients with chronic kidney disease in RSUD Prof. Dr.W. Z Johannes Kupang. This study employed an anon-reactive research design or unobtrusive research based on secondary data derived from medical record records at RSUD Prof. Dr.W. Johannes in August - September 2019 on 92 hemodialysis patients who met the inclusion criteria. The collected data were calculated with the SPSS application, while the correlation analysis between variables was performed by administering a linear regression analysis test. Ninety-two (92) respondents were obtained by employing the purposive sampling technique. The majority of patients with chronic kidney disease undergoing Hemodialysis were men (57.6%) with ages 39 - 59 years (63.0%), and the majority of patients undergoing Hemodialysis in patients with chronic kidney failure (CKD) were <12 months (41.3%). It was discovered that there was no relationship between the length of Hemodialysis with hemoglobin, hematocrit, serum iron, and total iron-binding capacity levels in patients with chronic kidney disease (CKD).

TMT Quantitative Proteomics Analysis Reveals the Effects of Transport Stress on Iron Metabolism in the Liver of Chicken

Abnormal iron metabolism can cause oxidative stress in broilers, and transport stress (TS) may potentially influence iron metabolism. However, the mechanisms by which TS affects iron metabolism are unclear. This study used quantitative proteome analysis based on tandem mass tag (TMT) to investigate the effects of TS on liver iron metabolism in broilers. Broilers (n = 24) reared under the same conditions were selected randomly into the transported group for 4 h (T2) and non-transported group (T1). Results showed that the serum iron level and total iron-binding capacity of broilers in the T2 were significantly higher than those in the T1 (p < 0.05). The liver iron content of broilers in the T2 (0.498 ± 0.058 mg·gprot−1) was significantly higher than that in the T1 (0.357 ± 0.035 mg·gprot−1), and the iron-stained sections showed that TS caused the enrichment of iron in the liver. We identified 1139 differentially expressed proteins (DEPs). Twelve DEPs associated with iron metabolism were identified, of which eight were up-regulated, and four were down-regulated in T2 compared with T1. Prediction of the protein interaction network for DEPs showed that FTH1, IREB2, and HEPH play vital roles in this network. The results provide new insights into the effects of TS on broilers’ liver iron metabolism.

Magnesium supplementation and iron status among female students: the intervention study

Background: Literature data indicate the benefit of magnesium (Mg) supplementation. The aim of this study was to examine the effect of short-term Mg supplementation on iron status in healthy female participants. Methods: One hundred healthy female students of the University of Belgrade - Faculty of Pharmacy participated in the study during eleven intervention days. Students ingested Mg preparations with the same dose of the active substance. The analysis included the measurement of serum iron, unsaturated iron binding capacity (UIBC), total iron binding capacity (TIBC), total Mg (tMg), ionized Mg (iMg), complete blood count, met-, carboxy- and oxy-haemoglobin (metHgb, COHgb, O2Hgb). Transferrin concentrations and the percentage of transferrin saturation (SAT) were calculated manually. The association among the analyzed biochemical parameters was examined using polynomial regression. A principal component analysis (PCA) was used for the evaluation of interdependence between the analyzed parameters. Results: A statistically significant trend for change in O2Hgb (%) by tertiles of iMg concentrations was found (P = 0.029). Serum tMg reached a significant positive correlation with the SAT at concentration levels greater than 0.9 mmol/L, after 11 days of intervention (R2=0.116). Ionized Mg in a concentration higher than 0.6 mmol/L is positively correlated with SAT and serum Fe (R2=0.214; 0.199, respectively). PCA revealed variability of 64.7% for two axes after 11 days. Conclusions: Mg supplementation leads to an improvement in certain iron status parameters even in individuals with optimal levels of these indices. However, caution should be exercised when supplementing Mg, and laboratory monitoring of the interaction is required.

HeGRI: A Novel Index of Serum Hepcidin Suppression in Relation to the Degree of Renal Dysfunction among β-Thalassemia Major Patients

Background: The progressive renal function inadequacy results in altered hepcidin metabolism due to a shifting of its renal elimination, which consequently affects enteric iron absorption and iron stores’ availability. This study aimed to investigate and correlate renal function, iron status, and hepcidin in patients with β-thalassemia major through a novel index. Methods: In this 1:1 case–control study, serum hepcidin, serum ferritin, iron study, hematological and renal function parameters were compared between 60 β-thalassemia major patients with iron overload and 61 healthy individuals (2–30 years old). Results: The concentrations of serum hepcidin (21.898 vs. 9.941 ng/mL; p < 0.001) and eGFR (179.71 vs. 132.95; p < 0.001) were significantly higher in β-thalassemia major patients compared to the controls. The serum hepcidin levels decreased with increasing levels of total iron-binding capacity (TIBC; β = −0.442; p = 0.024), transferrin saturation (β = −0.343; p = 0.023), serum creatinine (β = −0.625; p = 0.0030), and eGFR (β = −0.496; p = 0.011). The mean hepcidin/ferritin ratio was significantly lower in the β-thalassemia major cases (0.0069 vs. 0.3970; p < 0.001). The novel hepcidin/eGFR ratio index (HeGRI) was significantly higher in the patient group compared to controls (0.12 vs. 0.09; p = 0.031), respectively. Conclusions: These results suggest that HeGRI could be a potential index of the appropriateness of serum hepcidin suppression associated with the degree of renal dysfunction among β-thalassemia major patients.

Effective Antioxidant activity of Phytic acid Prevents Isoproterenol-Induced Myocardial Infarction in Albino wistar Rats

This study aimed to evaluate the preventive effect of phytic acid on cardiac markers, blood glucose, total proteins, albumin/globulin (A/G) ratio, serum uric acid, serum iron, and plasma iron binding capacity in isoproterenol (ISO)-induced myocardial infarction (MI) in male Wistar rats. Rats subcutaneously injected with ISO (85 mg/kg) at an interval of 24 h for 2 days showed a significant increase in the degrees of cardiac troponin T (cTnT), intensity of the bands of lactate dehydrogenase (LDH)-isoenzyme (LDH1 and LDH2) and the activities of cardiac marker enzymes such as creatine kinase-MB (CK-MB), creatine kinase (CK), lactate dehydrogenase (LDH), aspartate transaminase (AST) and alanine transaminase (ALT) in serum with subsequent decrease in the activities of CK, LDH, AST and ALT in the heart. ISO-induced rats showed a significant increase in blood glucose, serum uric acid, serum iron and a decrease in the levels of total proteins, A/G ratio and iron binding capacity. Pretreatment with phytic acid (25 and 50 mg/kg) daily for a period of 56 days positively altered the levels of cTnT, intensity of the bands of the LDH1 and LDH2-isoenzyme and the activities of cardiac marker enzymes, and other biochemical parameters. Thus, phytic acid possess cardioprotective effect in ISO-induced oxidative stress in rats.

Decreased Serum Iron Concentration and Total Iron Binding Capacity Are Associated With Serious Crohn’s Disease

Background: This study aimed to investigate whether serum indicators related to iron stores in the body are associated with clinical and endoscopic disease severity.Methods: Eighty-four patients with Crohn’s disease (CD) and twenty-four healthy volunteers were included. The indicators related to iron stores were detected within one week after endoscopic and CT enterography examinations.Results: Patients were divided into three groups according to the CDAI scores. Serum iron levels were decreased in all patient groups (p<0.05), and the values of remission group were higher than those of moderate group (p<0.001). The total iron binding capacity （TIBC） values of the moderate group were lower than those of the controls and the other patient groups (p<0.05). None of the indicators differed significantly among the patients classified by SES-CD (p>0.05). Underweight, decreased serum iron and TIBC were independent risk factors for moderate clinical disease. Combined detection of decreased serum iron and TIBC was helpful in differentiating severe patients. The sensitivity and specificity were 32.7% and 100%, respectively (AUC = 0.812, p<0.01).Conclusions: Decreases in serum iron and TIBC were associated with the clinical activity of CD. Combined detection of the two indicators was conducive to screening patients with serious disease.

Modification of physical and functional characteristics of chitin extracted from microwave-treated Nelumbo nucifera rhizome flour

Chitin, a cell wall polysaccharide, extracted from Nelumbo nucifera rhizome (NNR), was subjected to microwave treatment to modify its physical and functional characteristics. The NNR flour was irradiated at different levels of the microwave treatment period (1, 2, 3, 4, and 5 min). Chitin was extracted from the native and microwave-treated samples and analyzed for physical and functional characteristics. The microwave treatment resulted in some variations in the extract yield, structure, morphology, and composition of chitin that were directly correlated with its functional properties. Regression analysis of the data showed a significant ( p < 0.05) time-dependent linear decrease in extract yield, polynomial decrease in water-holding and swelling capacities, an exponential increase in oil holding, and an exponential decrease in iron-binding capacity of chitin extracted from microwave-treated flour. These variations in the studied functional properties may be due to microwave-induced hydrolytic degradation of chitin, structural rearrangements, and exposure of some lipophilic functional groups on the surface of chitin. The data would be a valuable contribution to the literature regarding microwave-induced modification in physical and functional characteristics of chitin present in N. nucifera rhizome and other plant-based biomaterials of industrial importance.