Pharmacokinetics and red cell utilization of iron(III) hydroxide–sucrose complex in anaemic patients: a study using positron emission tomography

Beshara, Soheir; Lundqvist, Hans; Sundin, Johanna; Lubberink, Mark; Tolmachev, Vladimir; Valind, Sven; Antoni, Gunnar; Långström, Bengt; Danielson, Bo G.

doi:10.1046/j.1365-2141.1999.01179.x

Cited by 79 publications

(56 citation statements)

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“…Al Momen et al [6], in their study compared 52 women treated with intravenous iron sucrose and 59 women treated with 300 mg oral iron sulfate. Intravenous iron sucrose complex group achieved significantly higher hemoglobin levels 128.5 ± 6.6 versus 111.4 ± 12.4 g/l in the oral iron group (P \ 0.001) in a shorter period 6.9 ± 1.8 versus 14.9 ± 3.1 weeks in control group (P B 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…Iron sucrose has an intermediate stability and strength. It is quickly cleared from the serum with the terminal half life of approximately 5-6 h. It is more rapidly available for erythropoiesis [5][6][7]. In the oral group, women were instructed to take two tablets (ferrous ascorbate with 100 mg of elemental iron per day with 1.1 mg of folic acid) twice daily throughout the pregnancy.…”

Section: Methodsmentioning

confidence: 99%

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Iron Deficiency Anemia in Pregnancy: Intravenous Versus Oral Route

Shafi

Purandare

Sathe

2012

J Obstet Gynecol India

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Objectives The aim of this study was to compare the efficacy and safety of intravenous iron with oral iron in the treatment of iron deficiency anemia of pregnancy. Methods A randomized experimental study was conducted at K. J. Somaiya Hospital involving 200 pregnant women with iron deficiency anemia. In the intravenous group iron dose was calculated from: Total iron dose required (mg) = 2.4 9 weight kg 9 target hemoglobinactual hemoglobin) g/dl ? 500. Target hemoglobin was set at 12 g/dl. In the oral group patients received 200 mg oral ferrous ascorbate daily. Hemoglobin and serum ferritin were reviewed at 2, 4, and 6 weeks. Paired and independent t test was applied. Results The change in hemoglobin and ferritin levels from baseline was significantly higher in the intravenous group than the oral group at each measurement (P = 0.000). Conclusion Intravenous iron elevates hemoglobin and restores iron stores faster than oral iron, with no severe adverse reactions.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Iron Deficiency Anemia in Pregnancy: Intravenous Versus Oral Route

Shafi

Purandare

Sathe

2012

J Obstet Gynecol India

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“…It may explain the failure to absorb dietary iron despite systemic iron deficiency, as well as the coexistent failure to respond to parenteral iron complexes, which must be processed and exported by macrophages before utilization. 107 Because overexpression of TMPRSS6 blocks activation of diverse pathways for upregulation of hepcidin, the overexpression or dysregulation of TMPRSS6 might cause iron overload, whereas mutational inactivation of TMPRSS6 (as in Mask mice) would lower body iron content. 103 This transcriptional effect might be achieved by cleaving a protein that up-regulates a pathway that normally represses hepcidin transcription, or that down-regulates a pathway that normally activates hepcidin transcription.…”

Section: Tmprss6 Mutantsmentioning

confidence: 99%

Molecular basis of inherited microcytic anemia due to defects in iron acquisition or heme synthesis

Iolascon¹,

Falco²,

Beaumont³

2009

Haematologica

133

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© F e r r a t a S t o r t i F o u n d a t i o nAIn this paper we will review the new information available on the iron acquisition pathway by developing erythrocytes and its regulation, and we will consider only inherited microcytosis due to heme synthesis or to iron metabolism defects. Iron and erythropoiesis Iron acquisition pathway in erythroid cellsDeveloping erythroid cells in the bone marrow acquire iron from the plasma iron-transferrin (Tf) complex, through the transferrin receptor (TfR) mediated pathway ( Figure 1). All proliferating cells express transferrin receptors on their cell surface at levels varying from 10 3 to 10 5 molecules per cell. Erythroid precursors, which have an extraordinary requirement for iron to allow for production of hemoglobin, may have over 10 6 transferrin receptors per cell.3 The transferrin-Fe(III) complex in plasma is transported into cells principally through transferrin receptor 1 (TfR1), which is expressed on all dividing cells and is particularly abundant on erythroid precursors. TfR2, encoded by a different gene, is expressed primarily in the liver and binds the transferrin-Fe(III) complex at a much lower affinity than TfR1 and appears to be a signaling molecule rather than an iron transporter. 4 At the pH of the cell surface, TfR1 binds only diferric transferrin. The Tf-Fe(III)/TfR1 complex is internalized into a clathrin-coated pit that, assisted by an adaptor protein complex designated AP-2, 5 rapidly matures to a proton-pumping, pH-lowering endosome. At the lowered pH, iron is released from Tf and subsequently reduced to Fe(II) and transported across the endosomal membrane by Divalent Metal Transporter 1 (DMT1).6 DMT1/Nramp2, a member of the Natural Resistance-Associated-Macrophage Protein (Nramp) family, is a proton-coupled divalent metal transporter found at the plasma membrane and in endosomes of cells of both the duodenum and peripheral tissues. Iron-depleted Tf is then returned to the cell surface where, again encountering a pH of 7.4, the protein is released for another cycle of iron transport. Recently, Steap3 (6-transmembrane epithelial antigen of the prostate 3), an endosomal ferrireductase that facilitates Tf-mediated uptake of iron in erythroid precursors has been identified. 8Steap3 is expressed highly in hematopoietic tissues, colocalizes with the Tf cycle endosome and facilitates Tfbound iron uptake. Erythroid cells from mice deficient in Steap3 (nm1054) are defective in Tf-dependent iron uptake, resulting in a hypochromic, microcytic anemia typical of iron deficiency 9 whereas overexpression of Steap3 stimulates the reduction of iron. Taken together, these findings indicate that Steap3 is an endosomal ferrireductase required for efficient Tf-dependent iron uptake in erythroid cells. However, nml054 and Steap3 −/− erythroid precursors retain some residual ferrireductase as well as iron uptake activity, indicating that there are other ways of reducing iron in the Tf-cycle endosome and/or that there are other endosomal iron transporters that are not res...

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“…Iron sucrose is effective because of the rapid removal from the plasma and the availability for erythropoiesis [15, 18]. After a bolus dose of iron sucrose, the plasma level peak occurs at 10 min.…”

Section: Discussionmentioning

confidence: 99%

Safety and Usefulness of Intravenous Iron Sucrose in the Management of Preoperative Anemia in Patients with Menorrhagia: A Phase IV, Open-Label, Prospective, Randomized Study

et al. 2009

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Background: The aim of this study was to compare the efficacy, safety and achievement of the target hemoglobin level (Hb ≥10 g/dl) in patients with preoperative anemia due to menorrhagia who received intravenous iron sucrose compared with oral iron protein succinylate for anemia management. Methods: Seventy-six patients with Hb levels <9.0 g/dl who were scheduled to undergo surgical treatment were randomized to receive either intravenous iron sucrose (based on the calculated total iron deficit divided into 2 ampoule infusions intravenously 3 times a week, beginning 3 weeks before surgery) or oral iron (80 mg/day of oral iron protein succinylate daily). Results: The intravenous iron group had higher increases in Hb (3.0 vs. 0.8 g/dl; p < 0.0001) and ferritin levels (170.1 vs. 4.1 μg/l; p < 0.0001) than the oral iron group. Achieving the target Hb was also higher in the intravenous iron group than in the oral iron group (76.7 vs. 11.5%; p < 0.0001). There were tolerable adverse events in both groups. Conclusion: Preoperative intravenous iron sucrose administration is more effective than oral iron and is as safe as oral iron therapy in the correction of preoperative anemia due to menorrhagia.

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Pharmacokinetics and red cell utilization of iron(III) hydroxide–sucrose complex in anaemic patients: a study using positron emission tomography

Cited by 79 publications

References 10 publications

Iron Deficiency Anemia in Pregnancy: Intravenous Versus Oral Route

Iron Deficiency Anemia in Pregnancy: Intravenous Versus Oral Route

Molecular basis of inherited microcytic anemia due to defects in iron acquisition or heme synthesis

Safety and Usefulness of Intravenous Iron Sucrose in the Management of Preoperative Anemia in Patients with Menorrhagia: A Phase IV, Open-Label, Prospective, Randomized Study

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