органогеРациональные комбинации в фармакотерапии железодефицита

Abstract

Iron deficiency remains one of the most common deficiencies worldwide. An inadequate and unbalanced diet may cause a lack of other nutrients necessary for hematopoiesis, which increases the risk of iron deficiency and makes it difficult to treat. Various pharmacotherapeutic approaches are being studied and applied, including combination medications, which in addition to iron consist of folic acid, copper/manganese gluconate, ascorbic acid, multivitamins, serine, and cyanocobalamin. Folate is a component that affects both the efficacy and safety of pharmacotherapy for iron deficiency. Preclinical animal studies comparing the dynamics of hematological indices confirmed a more rapid achievement of target values with the simultaneous use of iron and folic acid. Clinical studies in a group of pregnant women with iron-deficiency anemia (IDA) demonstrated that folic acid in combination with iron was more effective than iron as monotherapy. The combination of iron and folic acid is also rational in terms of increasing safety: folic acid prevents iron accumulation in the liver and the associated development of fibrosis. Ironinduced liver injury is related to oxidative stress catalyzed by iron overload. Folic acid regulates the transcription of genes involved in oxidative stress in the liver and the activity of 5'-AMP-activated protein kinase. Key words: iron deficiency, folic acid, hematopoiesis, rational pharmacotherapy