Dietary iron does not impact the quality of life of patients with quiescent ulcerative colitis: an observational study

Tolkien, Zoe; Pereira, Dora I. A.; Prassmayer, Laura; Fitt, Emily; Pot, Gerda K.; Greenfield, S.; Powell, Jonathan J.

doi:10.1186/1475-2891-12-152

Cited by 6 publications

(8 citation statements)

References 28 publications

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“…These changes were accompanied by a decreased relative abundance of Collinsella aerofaciens, Faecalibacterium prausnitzii, Ruminococcus bromii, and Dorea spp, of which the consequences are unknown. In contrast to earlier studies in IBD patients, [48][49][50][51][52] these shifts in the gut microbiome and metabolome were dissociated from changes in disease activity in these patients. 59 Interestingly, there is a trend toward the use of oral iron-based phosphate binders in CKD patients, in very large doses.…”

Section: Potential Consequences Of Oral Iron Therapy On Infection Imcontrasting

confidence: 85%

“…However, large doses of supplementary oral iron prescribed to these patients might have adverse effects on their intestinal health that is already affected due to the underlying disease. Iron may for instance negatively affect their inflamed leaky gut, as it has previously been shown to worsen the symptoms of the inflamed gut in patients with inflammatory bowel disease (IBD), thereby increasing gastrointestinal adverse effects such as nausea, diarrhea, and abdominal pain . Importantly, African infants receiving supplemental iron, show changes of the gut microbiome composition, with a decreased abundance of the generally beneficial barrier bacteria Lactobacillus spp.…”

Section: Potential Consequences Of Oral Iron Therapy On Infection Immentioning

confidence: 99%

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Oral iron supplementation: Potential implications for the gut microbiome and metabolome in patients with CKD

Kortman

Reijnders

Swinkels

2017

Hemodialysis International

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Patients with chronic kidney disease (CKD) and loss of kidney function are at increased risk for morbidity and mortality. The risks of CKD are attributed to "uremia," an increased concentration of uremic retention solutes (toxins) in the plasma. Recently, a colo-renal axis became clearly apparent and uremia has been associated with an altered gut microbiome composition and metabolism. There is a high prevalence of anemia in patients with CKD, for which patients are often treated with oral or intravenous iron. Recent in vivo and in vitro studies have reported adverse effects of oral iron supplementation on the gut microbiota composition, gut metabolome, and intestinal health, which in turn may result in an increased production of uremic toxins. It may also affect circulating levels of other microbe-derived molecules, that can act as mediators of immune regulation. Changes in body iron levels have also been reported to exert subtle effects on host immune function by modulating immune cell proliferation and differentiation, and by directly regulating cytokine formation and antimicrobial immune effector mechanisms. Based on the foregoing it is conceivable that oral iron supplementation in iron deficient predialysis CKD patients adversely changes gut microbiota composition, the gut and systemic metabolome, and host immunity and infection. Future studies are needed to confirm these hypotheses and to assess whether, compared to IV iron supplementation, oral iron supplementation negatively impacts on morbidity of CKD, and whether these adverse effects depend on the iron bioavailability of the iron formulation to the microbiota.

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Section: Potential Consequences Of Oral Iron Therapy On Infection Imcontrasting

confidence: 85%

Section: Potential Consequences Of Oral Iron Therapy On Infection Immentioning

confidence: 99%

Oral iron supplementation: Potential implications for the gut microbiome and metabolome in patients with CKD

Kortman

Reijnders

Swinkels

2017

Hemodialysis International

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“…Each question of the IBD-Q can have a score between 1 (“worst”) and 7 (“best”). The total score ranges from 32 to 224 with higher scores, indicating a better quality of life [30].…”

Section: Methodsmentioning

confidence: 99%

Intestinal Permeability Measured by Urinary Sucrose Excretion Correlates with Serum Zonulin and Faecal Calprotectin Concentrations in UC Patients in Remission

Wegh

Roos

Hovenier

et al. 2019

Journal of Nutrition and Metabolism

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Background and Aims. Ulcerative colitis (UC) is associated with an increased intestinal permeability, possibly through a dysbiosis of intestinal bacteria. We investigated which markers are most relevant to assess intestinal permeability in UC patients and whether probiotics had an effect on these markers. Methods. In this twelve-week placebo-controlled randomized double-blind study, twenty-five subjects with UC in remission received either placebo or a multispecies probiotics. Samples of blood, urine, and faeces were taken at baseline, week 6, and week 12 to assess intestinal permeability and inflammation. Diaries and Bristol stool scale were kept to record stool frequency and consistency. Quality of life was scored from 32–224 with the inflammatory bowel disease questionnaire (IBD-Q). Results. This group of UC patients, in clinical remission, did not show increased intestinal permeability at baseline of this study. During the study, no significant group or time effects were found for intestinal permeability measured by the 5-sugar absorption test, serum zonulin, and faecal zonulin. Likewise, the inflammatory markers C-reactive protein (CRP), calprotectin, and the cytokines IFNγ, TNFα, IL-6, and IL-10 were not significantly affected. Stool frequency and consistency were not significantly affected either. The IBD-Q score, 194 for the probiotics group and 195 for the placebo group, remained unaffected. Correlations were tested between all outcomes; urinary sucrose excretion was significantly correlated with serum zonulin (r = 0.62) and faecal calprotectin (r = 0.55). Faecal zonulin was not significantly correlated with any of the other markers. Conclusion. Serum zonulin may be a more relevant biomarker of intestinal permeability than faecal zonulin, due to its correlation with other biomarkers of intestinal permeability. UC patients in remission did not show an effect of the probiotic treatment or a change in gut permeability. This should not discourage further studies because effects might be present during active disease or shortly after a flare up.

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“…We, however, note that also intravenous iron therapy may not be without risk as this may induce iron overload (of reticulo‐endothelial stores in patients with inflammation) (Rostoker et al ., ). Finally, a recent study concluded that iron fortification is well tolerated in patients with quiescent IBD (absence of inflammation), but is contra‐indicated in patients with relapses (Tolkien et al ., ). A similar recent study confirmed the detrimental effect of oral iron administration in patients with forms of mildly active IBD (Powell et al ., ).…”

Section: How Pathogens Can Thrive On the Altered Nutritional Conditiomentioning

confidence: 97%

Nutritional iron turned inside out: intestinal stress from a gut microbial perspective

et al. 2014

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Iron is abundantly present on earth, essential for most microorganisms and crucial for human health. Human iron deficiency that is nevertheless highly prevalent in developing regions of the world can be effectively treated by oral iron administration. Accumulating evidence indicates that excess of unabsorbed iron that enters the colonic lumen causes unwanted side effects at the intestinal host-microbiota interface. The chemical properties of iron, the luminal environment and host iron withdrawal mechanisms, especially during inflammation, can turn the intestine in a rather stressful milieu. Certain pathogenic enteric bacteria can, however, deal with this stress at the expense of other members of the gut microbiota, while their virulence also seems to be stimulated in an iron-rich intestinal environment. This review covers the multifaceted aspects of nutritional iron stress with respect to growth, composition, metabolism and pathogenicity of the gut microbiota in relation to human health. We aim to present an unpreceded view on the dynamic effects and impact of oral iron administration on intestinal host-microbiota interactions to provide leads for future research and other applications.

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Dietary iron does not impact the quality of life of patients with quiescent ulcerative colitis: an observational study

Cited by 6 publications

References 28 publications

Oral iron supplementation: Potential implications for the gut microbiome and metabolome in patients with CKD

Oral iron supplementation: Potential implications for the gut microbiome and metabolome in patients with CKD

Intestinal Permeability Measured by Urinary Sucrose Excretion Correlates with Serum Zonulin and Faecal Calprotectin Concentrations in UC Patients in Remission

Nutritional iron turned inside out: intestinal stress from a gut microbial perspective

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