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Efficacy of Lactoferrin Oral Administration in the Treatment of Anemia and Anemia of Inflammation in Pregnant and Non-pregnant Women: An Interventional Study.

ABSTRACT: The discovery of the ferroportin-hepcidin complex has led to a critical review on the treatment of anemia and anemia of inflammation (AI). Ferroportin, the only known mammalian iron exporter from cells to blood, is negatively regulated by hepcidin, a hormone peptide able to bind to ferroportin, leading to its degradation. Therefore, new efficient therapeutic interventions acting on hepcidin and ferroportin are imperative to manage anemia and AI. Bovine milk derivative lactoferrin (bLf), a glycoprotein able to chelate two ferric ions per molecule, is emerging as a natural anti-inflammatory substance able to modulate hepcidin and ferroportin synthesis through the down-regulation of interleukin-6 (IL-6). Here, an interventional study (ClinicalTrials.gov Identifier: NCT01221844) was conducted by orally administering 100 mg of 20-30% iron-saturated bLf (corresponding to 70-84 ?g of elemental iron) twice a day. This treatment was compared with the Italian standard therapy, consisting in the oral administration of 329.7 mg of ferrous sulfate once a day (corresponding to 105 mg of elemental iron). Treatments were carried out on 29 anemic women with minor ?-thalassemia (20 pregnant and 9 non-pregnant), 149 women with hereditary thrombophilia (HT) (70 pregnant and 79 non-pregnant) affected by AI and 20 anemic pregnant women suffering from various pathologies. In anemic pregnant and non-pregnant women with minor ?-thalassemia, presenting undetectable hepcidin levels, differently from ferrous sulfate management, bLf decreased IL-6 (from 25 ± 8 to 6 ± 3 pg/ml) and increased total serum iron (TSI) (from 54 ± 17 to 80 ± 9 ?g/dl). BLf was also more efficient than ferrous sulfate in AI treatment in HT pregnant and non-pregnant women by decreasing both serum IL-6 (from 89 ± 8 to 58 ± 6 pg/ml) and hepcidin (from 115 ± 23 to 65 ± 10 ng/ml), thus increasing hematological parameters, such as the number of red blood cells (RBCs), the concentration of hemoglobin, TSI and serum ferritin. BLf was also efficient in treating anemia in other pathological pregnancies. Taken together all the results, bLf, showing a greater benefit and efficacy than the standard ferrous sulfate management, can be considered as a promising compound in treating anemia and AI through its ability to down-regulate IL-6, thus restoring ferroportin-mediated iron export from cells to blood in a hepcidin-dependent or independent way.

SUBMITTER: Lepanto MS

PROVIDER: S-EPMC6160582 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Efficacy of Lactoferrin Oral Administration in the Treatment of Anemia and Anemia of Inflammation in Pregnant and Non-pregnant Women: An Interventional Study.

Lepanto Maria Stefania MS Rosa Luigi L Cutone Antimo A Conte Maria Pia MP Paesano Rosalba R Valenti Piera P

Frontiers in immunology 20180921

The discovery of the ferroportin-hepcidin complex has led to a critical review on the treatment of anemia and anemia of inflammation (AI). Ferroportin, the only known mammalian iron exporter from cells to blood, is negatively regulated by hepcidin, a hormone peptide able to bind to ferroportin, leading to its degradation. Therefore, new efficient therapeutic interventions acting on hepcidin and ferroportin are imperative to manage anemia and AI. Bovine milk derivative lactoferrin (bLf), a glycop ...[more]

PMID: 30298070

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Project description:BACKGROUND:Globally, the prevalence of anemia among women of reproductive age is about 29.4%, and anemia impacts about 40% of pregnant women and more than 20% of non-pregnant women. We conducted a longitudinal observational study of anemia in pregnant and non-pregnant women, and analyzed the association between the prevalence of anemia and sociodemographic characteristics of women in southwest China. METHODS:This study was a longitudinal observational study which involved 640,672 women aged 18-49 years from 129 counties in southwest China. Data were from databases of National Free Preconception Health Examination Project (NFPHEP) and electronic medical records of local hospitals. We adjusted the diagnostic thresholds of anemia for altitude. The prevalence of anemia was expressed in percentages and 95% confidence intervals (95% CI). The association between the prevalence of anemia and sociodemographic characteristics of pregnant and non-pregnant women were analyzed using univariate and multivariate logistic regression method, expressed in crude odds ratio (cOR), adjusted odds ratio (aOR) and 95%CI. RESULTS:Of the 640,672 participants, 121,254 women suffered from anemia, with the prevalence of 18.9% (95%CI: 18.8-19.0%). From 2014 to 2018, the prevalence of anemia declines from 23.0-16.4%.The prevalence was 21.6% in the first trimester, higher than women in non-pregnancy (17.4%) and women in the third trimester (10.5%). Results from the multivariable logistic regression showed that women aged 18-20 (aOR?=?1.28) or over 35 years old (aOR?=?1.07), being farmers (aOR?=?1.42), being ethnic minorities (aOR: 1.19?~?1.73), during the first trimester (aOR?=?1.32) were more likely to be anemic. CONCLUSIONS:Although the anemia prevalence of women of reproductive age has been decreasing in recent years, the prevalence of anemia is still high in pregnant and non-pregnant women in southwest China, especially during the first trimester. Women who were older or younger, being farmers, being ethnic minorities were at high risk of anemia. Anemia in women of reproductive age cannot be neglected.

Project description:BackgroundAnemia is the most widely prevalent form of micronutrient deficiency that affects over a quarter of the global population. Evidence suggests that the burden of anemia is higher in the developing countries with women of reproductive age and children being the most at-risk groups. The most common causes are believed to be malnutrition and low bioavailability of micronutrients, which usually result from poor dietary habits and inadequate intake of food rich in micronutrients such as fresh fruits and vegetables. Regular consumption of F&V was shown to have protective effect against NCDs; however, evidence on this protective effect against micronutrient deficiency diseases are limited.Objectives(1) To measure the prevalence of anemia among adult non-pregnant women in Ghana, and (2) to investigate if there is any cross-sectional relationship between F&V consumption and anemia.MethodsThis is a cross-sectional study based on data extracted from the Ghana Demographic and Health Survey, 2008. Subjects were 4,290 non-pregnant women aged between 15 and 49 years. Hemoglobin levels were measured by HemoCue® hemoglobin-meter. Association between anemia and F&V consumption was assessed by multivariable regression methods.ResultsFindings indicate that well over half (57.9%) of the women were suffering from anemia of some level. The percentage of women consuming at least five servings of fruits and vegetables a day were 5.4% and 2.5% respectively. Results of multivariable analysis indicated that among urban women, consumption of <5 servings fruits/day was associated with significantly higher odds of severe [AOR = 9.27; 95% CI [5.15-16.70]] and moderate anemia [AOR = 6.63; 95% CI [4.21-10.44]], and consumption of <5 servings of vegetables/day was associated with higher odds of moderate anemia [AOR = 2.39; 95% CI [1.14-5.02]] compared with those who consumed >5 servings/day.ConclusionThe findings indicate that urban women who did not maintain WHO recommended level of F&V consumption bear a significantly higher likelihood of being moderate to severely anemic.

Dataset Information

Efficacy of Lactoferrin Oral Administration in the Treatment of Anemia and Anemia of Inflammation in Pregnant and Non-pregnant Women: An Interventional Study.

Publications

Efficacy of Lactoferrin Oral Administration in the Treatment of Anemia and Anemia of Inflammation in Pregnant and Non-pregnant Women: An Interventional Study.

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