Abstract
Chronic diseases are characterised by altered autophagy and protein metabolism disarrangement, resulting in sarcopenia, hypoalbuminemia and hypo-haemoglobinaemia. Hypo-haemoglobinaemia is linked to a worse prognosis independent of the target organ affected by the disease. Currently, the cornerstone of the therapy of anaemia is iron supplementation, with or without erythropoietin for the stimulation of haematopoiesis. However, treatment strategies should incorporate the promotion of the synthesis of heme, the principal constituent of haemoglobin (Hb) and of many other fundamental enzymes for human metabolism. Heme synthesis is controlled by a complex biochemical pathway. The limiting step of heme synthesis is D-amino-levulinic acid (D-ALA), whose availability and synthesis require glycine and succinil-coenzyme A (CoA) as precursor substrates. Consequently, the treatment of anaemia should not be based only on the sufficiency of iron but, also, on the availability of all precursor molecules fundamental for heme synthesis. Therefore, an adequate clinical therapeutic strategy should integrate a standard iron infusion and a supply of essential amino acids and vitamins involved in heme synthesis. We reported preliminary data in a select population of aged anaemic patients affected by congestive heart failure (CHF) and catabolic disarrangement, who, in addition to the standard iron therapy, were treated by reinforced therapeutic schedules also providing essential animo acids (AAs) and vitamins involved in the maintenance of heme. Notably, such individualised therapy resulted in a significantly faster increase in the blood concentration of haemoglobin after 30 days of treatment when compared to the nonsupplemented standard iron therapy.
Highlights
IntroductionNoncommunicable diseases account for 38 million deaths per year, according to the
When compared to the basal levels, only the experimental group receiving intravenous iron therapy plus integrated therapy demonstrated a significant increase in the haemoglobin concentration (Figure 4A,B), while no modification was observed in the group receiving the standard iron therapy only
The standard therapy of anaemia is primarily based on the supplementation of iron, with or without for hematopoiesis
Summary
Noncommunicable diseases account for 38 million deaths per year, according to the. World Health Organization [1]. Of these deaths, chronic diseases (CD) constitute a major cause of mortality. The most common CD include congestive heart failure (CHF), senescence, cancer, chronic obstructive pulmonary disease (COPD), diabetes, arthritis, asthma and some viral diseases such as hepatitis C and acquired immunodeficiency syndrome [2]. All CD are characterised by a hypercatabolic syndrome due to low-grade inflammation (caused by specific molecules such as cytokine, hormones, etc.), which induces metabolic alterations and muscular and globular protein disarray. Haemoglobin (Hb) is one of the most readily measureable in the blood
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.