Iron is found in almost all foods, so dietary iron intake is related to energy intake. However, its availability for absorption is quite variable, and poor bioavailability is a major reason for the high prevalence of nutritional iron deficiency anaemia. Absorption occurs primarily in the proximal small intestine through mature enterocytes located at the tips of the duodenal villi. Two transporters: Hem Carrier Protein 1 (HCP1) and Divalent Metal Transporter 1 (DMT1) appear to mediate the entry of most if not all dietary iron into these mucosal cells. Absorption is regulated according to the body's needs. The results of studies suggest that iron absorption is regulated by the control of iron export from duodenal enterocytes to the circulating transferrin pool by ferroportin. Hepcidin, a 25-amino acid polypeptide, which is synthesised primarily in hepatocytes, reduces the iron absorption from the intestine by binding to the only known cellular iron exporter, ferroportin, causing it to be degraded. Therefore, hepcidin is now considered to be the most important factor controlling iron absorption.
INTROduCTION Anemia of chronic disease (ACD) and iron-deficiency anemia (IDA) are common hematological conditions present in elderly patients. 1-3 They are a risk factor for cardiovascular diseases, contribute to fatigue, and negatively affect cognitive and physical functions as well as the quality of life. 4 ACD is a typically micro-or normocytic, normochromic anemia associated with chronic infections, chronic noninfectious inflammatory diseases, and malignancies. The pathogenesis of ACD is multifactorial. It involves impaired erythropoietin-dependent erythropoiesis caused by proinflammatory cytokines (interleukin 6 [IL-6], C-reactive protein [CRP], and tumor necrosis factor-α), impaired iron mobilization, and shortened red blood cell survival. 4-8 IDA develops, in the most part, due to chronic blood loss from the gastrointestinal tract, caused by aspirin or other nonsteroidal anti-inflammatories, ulcers, colon cancer, or diverticulosis. 3 Other causes of chronic blood loss or iron deficiency due to poor nutrition in this patient group are less likely. 9-12 In the elderly population, severe IDA may also affect the production of other proteins containing Fe 2+ , such as cytochromes, myoglobin, catalase, and peroxidase.
From a botanical point of view, a nut is a kind of dry, closed, unbroken, single-seeded fruit, which has a ligneous pericarp made up of several fruiting bodies surrounded by one free semen. The term “allergy to tree nuts” includes allergies to almonds, Brazil nuts, cashew nuts, hazelnuts, chestnuts, macadamia nuts, pecan nuts, pistachios and walnuts. All tree nuts belong to five orders of plants: Rosaceae, Fagales, Sapindales, Ericales and Proteales. Allergies to tree nuts usually start in childhood, but unlike other food allergies, they rarely fade away and generally persist throughout life. They are one of the main causes of serious allergic reactions ending in death in both children and adults. The epidemiology of allergy to nuts is variable and depends mainly on the geographical zone and eating habits. In northern Europe, hazelnut allergy is prevalent, whereas in the USA the most common is allergy to peanuts and, when taking tree nuts into consideration, to walnuts. The diagnosis of allergies to nuts is difficult and requires the use of the most modern research tools including molecular diagnostic techniques.
Summing up, the results of this study indicate that increased prohepcidin concentration, observed in obese elderly patients with anemia, may play an important role in iron deficiency development.
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