血清代谢组学揭示右旋糖酐铁的补铁潜在风险
创作:尹小甜 审核:Epi汪 04月30日
  • 纳入6个月大的恒河猴婴儿,其中10例铁充足,12例缺铁性贫血,给贫血组给予右旋糖酐铁和维生素B的肌肉注射;
  • 检测两组血清代谢组特征,发现基线时,两组婴儿之间有53种代谢产物不同;
  • 铁治疗使得干预组血红蛋白、平均红细胞体积等传统血液学指标恢复在正常值范围;
  • 但是铁治疗使其前后的代谢产物组发生明显变化,有323种差异代谢产物,集中在肝功能、胆汁酸释放、脂肪酸产生等方面;
  • 该研究提示,在使用铁补充治疗婴儿贫血时应谨慎。
主编推荐语
Epi汪
右旋糖酐铁是一种常见的抗贫血药,临床适用于不能耐受口服铁剂的缺铁性贫血或需要迅速纠正缺铁者。本研究通过动物实验发现,注射右旋糖酐铁对恒河猴婴儿的血清代谢组产生诸多影响,提示其可能具有潜在的毒性风险,需要进一步的研究。这也提示,该药物在儿童中使用时应加注意。
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Correcting iron deficiency anemia with iron dextran alters the serum metabolomic profile of the infant Rhesus Monkey

用右旋糖酐铁纠正缺铁性贫血可改变婴儿恒河猴的血清代谢组学

10.1093/ajcn/nqaa393

03-19, Article

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Background: The effects of infantile iron deficiency anemia (IDA) extend beyond hematological indices and include short and long-term adverse effects on multiple cells and tissues. IDA is associated with an abnormal serum metabolomic profile, characterized by altered hepatic metabolism, lowered NAD flux, increased nucleoside levels, and a reduction in circulating dopamine levels.
Objectives: The objective of this study was to determine whether the serum metabolomic profile is normalized after rapid correction of IDA using iron dextran injections.
Methods: Blood was collected from iron-sufficient (IS; n = 10) and IDA (n = 12) rhesus infants at 6 months of age. IDA infants were then administered iron dextran and vitamin B via intramuscular injections at weekly intervals for 2 to 8 weeks. Their hematological and metabolomic statuses were evaluated following treatment and compared with baseline and a separate group of age-matched IS infants (n = 5).
Results: Serum metabolomic profiles assessed at baseline and after treatment via HPLC/MS using isobaric standards identified 654 quantifiable metabolites. At baseline, 53 metabolites differed between IS and IDA infants. Iron treatment restored traditional hematological indices, including hemoglobin and mean corpuscular volume, into the normal range, but the metabolite profile in the IDA group after iron treatment was markedly altered, with 323 metabolites differentially expressed when compared with an infant’s own baseline profile.
Conclusions: Rapid correction of IDA with iron dextran resulted in extensive metabolic changes across biochemical pathways indexing the liver function, bile acid release, essential fatty acid production, nucleoside release, and several neurologically important metabolites. The results highlight the importance of a cautious approach when developing a route and regimen of iron repletion to treat infantile IDA.

First Authors:
Brian J Sandri

Correspondence Authors:
Raghavendra B Rao

All Authors:
Brian J Sandri,Gabriele R Lubach,Eric F Lock,Pamela J Kling,Michael K Georgieff,Christopher L Coe,Raghavendra B Rao

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