Improve Iron Bioavailability Research Articles

Iron chelation capacity and prediction of peptide binding modes identified in California red worm hydrolysates and effects on iron bioavailability in differentiated Caco-2 cells

Metal-chelating peptides represent an alternative for overcoming iron deficiencies, a common nutritional disease affecting populations worldwide. This study explored the iron-chelating activity of California red worm hydrolysates (WH) and its fractions. WH was obtained by hydrolysis with Alcalase 2.4 L and fractionated using a ceramic membrane with molecular weight cutoff 3 kDa. Both the complete hydrolysate and its fractions were assessed for their in-vitro iron-chelating activity and their ability to improve iron bioavailability through ferritin formation by differentiated Caco-2 cells assay. Finally, peptides in the fraction with the highest activity were sequenced by LC-MS/MS analysis and molecular docking was performed to elucidate the chelation mechanism. The findings reveal that the smallest fraction (F < 3 kDa) exhibits the most potent iron-chelating activity with IC50 value like carnosine. Moreover, in intestinal-like differentiated Caco-2 cells, this fraction enhances iron bioavailability in a remarkable 77.9% in comparison to FeSO4 alone. On the other hand, the peptide SLLDDRLDEK identified in this fraction presents the lowest value of affinity energy (−1.5 kcal/mol) and exhibits specific interactions with iron, allowing iron ions to be trapped within its structure. These results underscore the potential of F < 3 kDa fractions from WH as promising candidates for increasing iron bioavailability and addressing iron deficiency and related health concerns.

Advances in Iron Deficiency Anaemia Management: Exploring Novel Drug Delivery Systems and Future Perspectives.

Iron Deficiency Anaemia (IDA) is a prevalent global health issue characterized by inadequate iron levels in the body, leading to impaired red blood cell production and subsequent anaemia. Traditional treatment approaches for IDA, such as oral iron supplementation, often encounter challenges related to poor compliance, gastrointestinal side effects, and variable absorption rates. As a result, there is a growing interest in exploring novel drug delivery systems to enhance iron therapy efficacy and patient outcomes. This review discusses recent advances in IDA management, focusing on developing and utilizing innovative drug delivery systems for iron supplementation. Various strategies, including nanoformulations, microparticles, liposomes, and hydrogels, are explored for their potential to improve iron bioavailability, reduce adverse effects, and optimize therapeutic outcomes. Furthermore, promising strategies for the future management of IDA are explored, including the utilization of advanced technologies such as targeted drug delivery systems, controlled release mechanisms, and combination therapies. The integration of these novel drug delivery systems with advancements in diagnostics, personalized medicine, and patient-centered care holds great potential to revolutionize the management of IDA and improve the quality of life for individuals affected by this condition.

Effects of Pea (Pisum sativum) Prebiotics on Intestinal Iron-Related Proteins and Microbial Populations In Vivo (Gallus gallus).

Iron deficiency remains a public health challenge globally. Prebiotics have the potential to improve iron bioavailability by modulating intestinal bacterial population, increasing SCFA production, and stimulating expression of brush border membrane (BBM) iron transport proteins among iron-deficient populations. This study intended to investigate the potential effects of soluble extracts from the cotyledon and seed coat of three pea (Pisum sativum) varieties (CDC Striker, CDC Dakota, and CDC Meadow) on the expression of BBM iron-related proteins (DCYTB and DMT1) and populations of beneficial intestinal bacteria in vivo using the Gallus gallus model by oral gavage (one day old chicks) with 1 mL of 50 mg/mL pea soluble extract solutions. The seed coat treatment groups increased the relative abundance of Bifidobacterium compared to the cotyledon treatment groups, with CDC Dakota seed coat (dark brown pigmented) recording the highest relative abundance of Bifidobacterium. In contrast, CDC Striker Cotyledon (dark-green-pigmented) significantly increased the relative abundance of Lactobacillus (p < 0.05). Subsequently, the two dark-pigmented treatment groups (CDC Striker Cotyledon and CDC Dakota seed coats) recorded the highest expression of DCYTB. Our study suggests that soluble extracts from the pea seed coat and dark-pigmented pea cotyledon may improve iron bioavailability by affecting intestinal bacterial populations.

Effects of blending ratios variation on micronutrient compositions and phytate/minerals molar ratios of dabi teff-field pea based novel composite complementary flours

Mixtures of multiple grains at varied ratios can provide multiple and higher micronutrients than a single grain. Thus, this research was aimed at examining the effect of blending ratios variation on micro-compositions and phytate/minerals molar ratios of pre-processed local dabi teff-field pea based novel composite complementary flours. Inductively Coupled Plasma-Optical Emission Spectrometry was used to determine dietary minerals. Nutrisurvey software was employed to define ranges of the mixture components and they were constrained at 20–35% for dabi teff, 0–30% field pea and 5–20% maize, while the remaining were set constant at 25% barley, 15% oats and 5% linseed. Design-Expert ® software version 11, D-optimal was used to generate eleven experimental blends and to examine the effects of blending ratio variation on the responses. Mean mineral contents were significantly different (P < 0.05) among the blends (as affected by component ratios variation) and ranged from 24.01–31.58 mg/100 g for iron, 73.46 -78.81 mg/100 g for calcium, and 2.33–2.61 mg/100 g for zinc contents. The phytate/minerals molar ratios were significantly different among the blends except phytate/calcium molar ratio (Ph:Ca), ranged from 0.232–0.344 for phytate/iron molar ratio (Ph:Fe), 0.067–0.085 for (Ph:Ca), 3.356–4.18 for phytate/zinc molar ratio (Ph:Zn) and 6.457–7.943 for phytate by calcium to zinc molar ratio (Ph*Ca:Zn). A linear model was significant (P < 0.05) and adequate to describe variations in iron, zinc, Ph:Fe, Ph:Zn and Ph*Ca:Zn. There was a remarkably linear increase in iron and calcium contents with an increased dabi teff ratio in the blends accompanied by a significant decrease (P < 0.05) in phytate/minerals molar ratios. The findings showed that increasing dabi teff ratio in the blends notably increased iron content with reduced Ph:Fe molar ratio, providing the bases for developing iron-dense novel composite complementary flour with improved iron bioavailability to combat iron deficiency anemia among children.Graphical

Efficacy and Safety of Oral Supplementation with Liposomal Iron in Non-Dialysis Chronic Kidney Disease Patients with Iron Deficiency.

Iron deficiency is common in patients with non-dialysis-dependent chronic kidney disease (NDD-CKD). Oral iron supplementation is recommended in these patients, but it is associated with a higher incidence of gastrointestinal adverse reactions. Liposomal iron therapy has been proposed as a new iron formulation, improving iron bioavailability with less side effects; however, few data are available in patients with NDD-CKD. We designed a single-arm pilot study to evaluate the efficacy of liposomal iron administered for six months in correcting iron deficiency (defined as serum ferritin < 100 ng/mL and/or transferrin saturation < 20%) in patients with NDD-CKD stages 1-5. The primary endpoints were the achievement of serum ferritin ≥ 100 ng/mL and transferrin saturation ≥ 20%. Secondary outcomes were hemoglobin (Hb) changes and the safety of liposomal iron. The efficacy population included 34/38 patients, who completed at least one visit after baseline. Liposomal iron increased the achievement of transferrin saturation targets from 11.8% at baseline to 50.0% at month 6 (p = 0.002), while no significant correction of serum ferritin (p = 0.214) and Hb was found (p = 0.465). When patients were stratified by anemia (Hb < 12 g/dL in women and Hb < 13 g/dL in men), a significant improvement of transferrin saturation was observed only in anemic patients (from 13.3 ± 5.8% to 20.2 ± 8.1%, p = 0.012). Hb values slightly increased at month 6 only in anemic patients (+0.60 g/dL, 95%CI -0.27 to +1.48), but not in those without anemia (+0.08 g/dL, 95%CI -0.73 to +0.88). In patients taking at least one dose of liposomal iron (safety population, n = 38), the study drug was discontinued in eight patients due to death (n = 2), a switch to intravenous iron (n = 2), and the occurrence of side effects (n = 4). The use of liposomal iron in patients with NDD-CKD is associated with a partial correction of transferrin saturation, with no significant effect on iron storage and Hb levels.

Preparation, characterization, and bioavailability evaluation of antioxidant phosvitin peptide-ferrous complex.

Iron deficiency anemia (IDA) is one of the commonest global nutritional deficiency diseases, and the low bioavailability of iron is a key contributing factor. The peptide-iron complex could be used as a novel iron supplement to improve iron bioavailability. In this study, antioxidant low molecular weight (<3 kDa) phosvitin peptide (named PP-4) was separated to prepare a phosvitin peptide-ferrous complex (named PP-4-Fe); then the structural conformation of PP-4-Fe was characterized and its bioavailability by in vitro digestion was evaluated. The results showed that PP-4 had good ferrous-binding activity with 96.14 ± 2.86 μg Fe2+ mg-1 , and had a strong antioxidant effect with 995.61 ± 79.75 μmol TE mg-1 in 2,2'-azinobis'3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and 62.3 ± 3.95 μmol FeSO4 mg-1 in ferric ion reducing antioxidant power (FRAP). After ferrous binding, the FRAP activity of PP-4-Fe, enhanced by 1.8 times, formed a more ordered structure with an increase in α-helix and decrease in γ-random coil. The ferrous binding sites of PP-4 involved were the amino, carboxyl, imidazole, and phosphate groups. The PP-4-Fe complex displayed excellent gastrointestinal stability and antioxidant effects during digestion. The iron dialysis percentage of PP-4-Fe was 74.59% ± 0.68%, and increased to 81.10% ± 0.89% with the addition of 0.25 times vitamin C (VC). This indicated that PP-4-Fe displayed excellent bioavailability and VC in sufficient quantities had a synergistic effect on improving bioavailability. This study demonstrated that antioxidant phosvitin peptide was an efficient delivery system to protect ferrous ions and suggested that the phosvitin peptide-ferrous complex has strong potential as a ferrous supplement. © 2023 Society of Chemical Industry.

Spray Encapsulation of Iron in Chitosan Biopolymer for Tea Fortification

Aim. Tea was studied as a carrier for iron in a fortification strategy to reduce iron deficiency. Iron forms insoluble coloured complexes with tea polyphenols which lower consumer acceptability. Complexation of iron by polyphenols and quinones derived from tea inhibits iron absorption in the first segment of the small intestine. Spray-dried chitosan-iron microcapsules were prepared to prevent iron-polyphenol interaction before the beverage is consumed. A competing chelating agent (EDTA) or antioxidant (sodium ascorbate) was added to prevent interactions and help improve iron bioavailability. Methods. The effect of concentration of chitosan (0.2–1.5%w/w), iron loading (10–60% w/w FeSO4), addition of secondary coatings on particle morphology, surface iron exposure and release, and bioaccessibility were evaluated. Tea-containing chitosan microcapsules and chelating agents to enable iron absorption were evaluated for sensory acceptability. Results. The iron release profile at pH 1 and pH 7 exhibited reverse enteric behaviour of non-cross-linked chitosan microcapsules. Increasing the iron content leads to more iron exposure on the surface due to a high core to coat ratio. Cross-linked chitosan effectively encapsulated iron, and its release in tea was inhibited, as indicated by lower delta E values in comparison with untreated tea and positive sensory testing scores. The use of maltodextrin as secondary coating slightly improved the spray process and produced larger particles, with less exposed iron on the surface. However, it did not improve the colour performance in milk tea. Conclusions. Tea fortified with encapsulated iron and a chelating agent providing 40% of the daily iron requirement of an adult, prepared in a traditional South Asian manner, i.e., with milk and water, resulted in tea with acceptable colour and taste. However, further research is required to develop an encapsulation formulation for stable iron encapsulation in hot tea and exploration of equivalent plant-based chitosan sources to address concerns of consumers with dietary restrictions.

Extrusion and drying temperatures enhance sensory profile and iron bioavailability of dry bean pasta

Bean flour is a highly nutritive, plant-based ingredient with the potential for great utility in many food products. Heat treated flours produced from commercial varieties of white kidney, yellow and black beans, were processed into pastas using high\\low extrusion and drying temperatures. Bean pastas made with high extrusion\\high drying temperature (H\\H) had more favorable sensory attributes and better texture than those made with high extrusion\\low drying temperature (H\\L). Whereas bean pastas made with low extrusion\\low drying temperature (L\\L) were unacceptable. H\\H pastas favored longer cooking time (8.6 – 13.8 min) versus those extruded at lower temperature (5.0 – 5.7 min). High extrusion temperature (100 °C) with drying temperature high (90 °C) improved iron bioavailability from yellow and white kidney bean pastas, 12.7 and 15 ng ferritin/mg protein, respectively as compared to black bean pasta (0.9 ng ferritin/mg protein). Cultivar, extrusion and drying temperatures are critical for producing bean pastas with high iron bioavailability.

Matrices of Native and Oxidized Pectin and Ferrous Bisglycinate and Their In Vitro Behavior through Gastrointestinal Conditions

Colloidal matrices of native and oxidized pectin were developed to improve iron bioavailability through the digestive tract. Ferrous bisglycinate (Gly-Fe), obtained by precipitation of glycine chelation to Fe2+, was mixed with native and peroxide-oxidized citrus pectin, and subsequently lyophilized. Controls included matrices with iron and glycine without chelation. The resulting samples were characterized through FTIR, SEM, and TGA/DSC before and after in vitro digestion, which was performed in simulated salivary, gastric, and intestinal fluids. During these digestions, swelling capacity and iron release were assessed. All matrix formulations were porous, and while pectin oxidation did not alter architecture, it changed their properties, increasing thermal stability, likely due to greater number of interaction possibilities through carbonyl groups generated during oxidation. This also resulted in lower swelling capacity, with greater stability observed when using the chelated complex. Higher swelling was found in gastric and intestinal fluids. Pectin oxidation also increased retention of the chelated form, contrary to what was observed with unchelated iron. Thus, there is an important effect of pectin oxidation combined with iron in the form of ferrous biglyscinate on matrix stability and iron release through the digestive tract. These matrices could potentially improve iron bioavailability, diminishing organoleptic changes in fortified iron foods.

Extrusion cooking of food‐to‐food fortified wholegrain sorghum‐based porridges enhances Caco‐2 ferritin formation

AbstractBackground and ObjectivesIron deficiency is still a major public health concern in sub‐Saharan Africa, and this is in part due to a monotonous diet of cereals often low in bioavailable minerals and high in mineral bioavailability inhibitors, notably phytate and polyphenols. Sorghum is a major food crop across the semi‐arid tropics in Africa because of its tolerance to high temperature and low rainfall. Extrusion cooking is a process that applies high heat, pressure, and shear to raw food materials to produce ready‐to‐eat products. The application of high heat, pressure, and shear can destroy anti‐nutrients in plant foods and hence enhance the bioavailability of minerals. Food‐to‐food fortification (FtFF) is a strategy where micronutrient‐rich food combinations are used to promote the bioavailability of essential micronutrients by increasing the content of micronutrient bioavailability enhancers. The objective of this study was to determine the effects of extrusion cooking of wholegrain sorghum‐based porridges fortified with baobab fruit powder and moringa leaf powder on iron bioaccessibility.FindingsAlthough extrusion reduced bioaccessible iron content (BIC) and percentage bioaccessible iron (PBI), it enhanced ferritin‐formation in Caco‐2 cells (by 38%) compared to conventional cooking, most probably because extrusion reduced contents of phenolics and phytate, hence freeing more iron. Fortification with baobab increased PBI by 14%–34% whether extruded or conventionally cooked, probably due to its organic acids. Fortification with moringa reduced BIC and PBI (by 30% and 71%, respectively) whether extruded or conventionally‐cooked, probably due to its high calcium and phytate contents.ConclusionExtrusion cooking has the potential to help alleviate iron deficiency in sorghum‐based foods because it reduces the content of anti‐nutrients.Significance and NoveltyThis study highlights the potential of extrusion cooking coupled with fortification with tropical foodstuffs high in organic acids to improve iron bioavailability in wholegrain‐based starchy staple foods.

Iron Absorption: Factors, Limitations, and Improvement Methods

Iron is an essential element for human life since it participates in many functions in the human body, including oxygen transport, immunity, cell division and differentiation, and energy metabolism. Iron homeostasis is mainly controlled by intestinal absorption because iron does not have active excretory mechanisms for humans. Thus, efficient intestinal iron bioavailability is essential to reduce the risk of iron deficiency anemia. There are two forms of iron, heme and nonheme, found in foods. The average daily dietary iron intake is 10 to 15 mg in humans since only 1 to 2 mg is absorbed through the intestinal system. Nutrient–nutrient interactions may play a role in dietary intestinal iron absorption. Dietary inhibitors such as calcium, phytates, polyphenols and enhancers such as ascorbic acid and proteins mainly influence iron bioavailability. Numerous studies have been carried out for years to enhance iron bioavailability and combat iron deficiency. In addition to traditional methods, innovative techniques are being developed day by day to enhance iron bioavailability. This review will provide information about iron bioavailability, factors affecting absorption, iron deficiency, and recent studies on improving iron bioavailability.

An In Vitro Analysis and In Vivo Trial Demonstrating the Improved Iron Bioavailability of White Beans (Phaseolus vulgaris L.) After Processing Into Pasta

Abstract Objectives The cotyledon cell wall of the common bean can be a factor in Fe bioavailability. This study evaluated the iron bioavailability of two bean varieties (white or black) either boiled (intact cell walls) or extruded into pasta formulated from heat treated bean flour as the major ingredient (100% bean flour; broken cell walls). Methods In vitro Fe bioavailability was determined via the Caco-2 Cell Bioassay. In vivo Fe bioavailability was measured by the capacity of a bean-based or bean pasta-based diet to generate and maintain total body hemoglobin iron (Hb-Fe) during a 6 week poultry feeding trial. Results The iron and phytate concentrations of the bean-based and bean pasta-based diets consisting of tomato paste, carrot, cabbage, milk, potato and corn oil were not significantly different. The Caco-2 cell bioassay predicted that the white bean pasta diet would have the highest Fe bioavailability, closely followed by the white bean diet. The bioassay predicted the black bean diet and the black bean pasta diet would have significantly lower Fe bioavailability. For the in vivo studies, animals fed the white bean pasta diet (broken cell walls) had significantly (p ≤ 0.05) higher hemoglobin, Hb-Fe and hemoglobin maintenance efficiencies than animals fed a white bean, black bean or black bean pasta-based diet. Although cotyledon cells were broken, the iron bioavailability of the black bean pasta was not improved after processing into pasta. The low iron bioavailability of black beans was associated with their high concentrations of seed coat procyanidin, cinnamtannin and anthocyanidin compounds that have a negative impact on the absorption of iron. Conclusions This study shows that white colored dry bean possesses a combination of traits that result in improved iron bioavailability after processing into pasta. The enhanced Fe bioavailability from the white bean pasta is likely due to the breakage of the cotyledon cell wall during processing, thus allowing enhanced bioaccessibility of the intracellular Fe. In the black bean pasta diet, this enhancement was not observed due to the presence of the seed coat polyphenols which interacted with the released intracellular Fe and prevented Fe absorption. Funding Sources Funded by the United States Department of Agriculture, Agricultural Research Service.

A Natural Low Phytic Acid Finger Millet Accession Significantly Improves Iron Bioavailability in Indian Women

Iron deficiency and anemia are common in low- and middle-income countries. This is due to a poor dietary iron density and low iron absorption resulting from the high inhibitory phytic acid content in cereal and millet-based diets. Here, we report that a naturally occurring low phytic acid finger millet accession (571 mg 100 g−1), stable across three growing seasons with normal iron content (3.6 mg 100 g−1), increases iron absorption by 3-folds in normal Indian women. The accessions differing in grain phytic acid content, GE 2358 (low), and GE1004 (high) were selected from a core collection of 623 accessions. Whole genome re-sequencing of the accessions revealed significant single nucleotide variations segregating them into distinct clades. A non-synonymous mutation in the EcABCC phytic acid transporter gene between high and low accessions could affect gene function and result in phytic acid differences. The highly sensitive dual stable-isotope erythrocyte incorporation method was adopted to assess the fractional iron absorption. The low phytic acid accession resulted in a significantly higher iron absorption compared with the high phytic acid accession (3.7 vs. 1.3%, p < 0.05). The low phytic acid accession could be effective in preventing iron deficiency in regions where finger millet is habitually eaten. With its low water requirement, finger millet leaves low environmental footprints and hence would be an excellent sustainable strategy to mitigate iron deficiency.

Application of Aureobasidium pullulans in iron‐poor soil. Can the production of siderophores improve iron bioavailability and yeast antagonistic activity?

AbstractIron is a fundamental element for plants as well as for microorganisms and several pathogens, including Rhizoctonia solani, one of the main soil‐borne pathogens of tomato. This study demonstrated the ability of Aureobasidium pullulans strain L1 to produce siderophores and how these molecules were, directly and indirectly, connected to its antagonistic activity and iron bioavailability. By ICP‐OES (Inductively Coupled Plasma—Optical Emission Spectroscopy) trace analysis, the strain displayed the ability to increase the bioavailability of Fe (II) in the soil by almost 50% 30 days after inoculation. Also, the bioavailability of Mn, Cu and Zn was increased after 30 days of incubation in the soil by 31.8, 38.4 and 27.1%, respectively. In in vivo assays, A. pullulans L1 strain showed a growth promotion of tomato roots length and stem diameter, respectively, by 19.1 and 27.3%, and acted as a biocontrol agent (BCA) against R. solani (80% of inhibition). The results demonstrate a new aspect of this microorganism, usually applied as an antagonist of postharvest fruit diseases, to explore in different environments and against different pathogens, such as soil‐borne pathogens.

Faster cooking times and improved iron bioavailability are associated with the down regulation of procyanidin synthesis in slow-darkening pinto beans (Phaseolus vulgaris L.)

Abstract Seed coat darkening after a delayed harvest or prolonged storage reduces the commercial value of dry beans and is caused by the oxidation of procyanidin compounds (condensed tannins). Slow-darkening (SD) pinto beans have a recessive gene (Psd), which alters procyanidin production – postponing their darkening over time. Procyanidins are important for the processing and nutrient bioavailability of beans, therefore, this study compared the postharvest cooking times and iron bioavailability of SD pinto varieties to regular-darkening (RD) pinto varieties. The results show SD pinto beans cook 30% faster and provide 2–7 times more bioavailable iron than RD pinto beans. No relationship between iron bioavailability, iron and phytate concentrations were detected among the pinto beans. However, lower procyanidin concentrations were strongly associated with faster cooking times and improved iron bioavailability of SD pinto beans. These findings indicate that the SD trait benefits the cooking quality and iron bioavailability of stored beans.

Iron intake among Lebanese women: sociodemographic factors, iron-rich dietary patterns, and preparation of hummus, a Mediterranean dish.

BackgroundPlant-based foods such as hummus are alternative to animal protein, and when properly prepared, they help to alleviate nutritional iron deficiency that leads to anemia, a global health problem.ObjectiveThe objective was to assess iron intake among Lebanese women and related participant’s characteristics, discern iron-rich dietary patterns, evaluate their association with nutrients intake and participant’s sociodemographic characteristics, and identify the women preparing hummus traditionally and properly for an enhanced iron bioavailability.DesignA cross-sectional study of 400 Lebanese women (18–74 years old) was conducted in Lebanon. Data from a questionnaire, including sociodemographic and health characteristics, dietary intake, and hummus preparation and consumption, were collected. Dietary data were obtained by a food frequency questionnaire and a 24-h recall. Dietary patterns were identified by principal component analysis. Linear regression and binomial logistic regression models were used to explore the association between the intake of dietary iron, its patterns, and the participants’ characteristics.ResultsAbout 60% of the women had iron intake deficiency, especially with lower income (odds ratio [OR] = 1.88, 95% confidence interval [CI]: 1.107, 3.194). Four iron-rich dietary patterns were identified: legumes; organ/lunch meat and chicken; canned fish; and beef and hummus. The factor scores of the latter were positively correlated with protein, vitamin C, iron, folate, vitamin B12, and vitamin A with r = 0.195 and P < 0.01 for all. No significant difference was shown among the women’s sociodemographic characteristics for the consumption of the hummus-related pattern. Only 9.2 and 22.7% of the women considered proper preparation of chickpea and hummus, respectively, which significantly (P < 0.05) correlated with older women (66.7%).Discussion & ConclusionThe majority of the Lebanese women still have iron intake deficiency and the minority reported proper preparation of hummus. Intervention programs spreading awareness among Lebanese women are needed for encouraging adequate iron intake and considering proper steps to improve iron bioavailability from plant-based food.

Roxadustat (Evrenzo® tablet), a therapeutic drug for renal anemia: pharmacological characteristics and clinical evidence in Japan

Roxadustat (Evrenzo® tablet) is an oral hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitor. Roxadustat has been approved for the treatment of renal anemia in patients on dialysis in September 2019 in Japan. By inhibiting HIF-PH, roxadustat suppresses the degradation of HIF-α, a subunit of the heterodimeric transcription factor HIF, leading to its accumulation and activation of the HIF pathway. Similar to activation of the HIF pathway in response to hypoxia, the production of endogenous erythropoietin is increased and erythropoiesis is stimulated. Moreover, roxadustat stimulates erythropoiesis efficiently by improving iron bioavailability. The efficacy and mechanism of action of roxadustat have been detailed in non-clinical pharmacology studies. Rat models of anemia demonstrated efficacy of roxadustat in correcting anemia and changes in gene expression leading to increased iron bioavailability. Four phase 3 clinical studies in Japan clearly demonstrated the efficacy of roxadustat in patients with renal anemia on dialysis. Roxadustat showed an acceptable safety profile, and the incidences and types of adverse events and serious adverse events reported in the clinical studies were similar with those predicted to occur in these patient population. Since roxadustat is an oral drug, concerns present with erythropoiesis-stimulating agents (ESAs) such as the risk of infection to the medical staff due to accidental needle-stick, pain during ESA injection in patients and burden on patients to visit a hospital, can be avoided or reduced. In November 2020, roxadustat has also been approved for the treatment of renal anemia in patients not on dialysis (data not shown in this article).

Comparative Evaluation of Intestinal Absorption and Functional Value of Iron Dietary Supplements and Drug with Different Delivery Systems.

Iron is a fundament micronutrient, whose homeostasis is strictly regulated. Iron deficiency anemia is among the most widespread nutritional deficiencies and its therapy, based on dietary supplement and drugs, may lead to severe side effects. With the aim of improving iron bioavailability while reducing iron oral therapy side effects, novel dietary supplements based on innovative technologies—microencapsulation, liposomes, sucrosomes—have been produced and marketed. In the present work, six iron dietary supplements for different therapeutic targets were compared in terms of bioaccessibility, bioavailability, and safety by using an integrated in vitro approach. For general-purpose iron supplements, ME + VitC (microencapsulated) showed a fast, burst intestinal iron absorption kinetic, which maintained iron bioavailability and ferritin expression constant over time. SS + VitC (sucrosomes), on the other side, showed a slower, time-dependent iron absorption and ferritin expression trend. ME + Folate (microencapsulated) showed a behavior similar to that of ME + VitC, albeit with a lower bioavailability. Among pediatric iron supplements, a time-dependent bioavailability increase was observed for LS (liposome), while PIC (polydextrose-iron complex) bioavailability is severely limited by its poor bioaccessibility. Finally, except for SS + VitC, no adverse effects on intestinal mucosa vitality and barrier integrity were observed. Considering obtained results and the different therapeutic targets, microencapsulation-based formulations are endowed with better performance compared to the other formulations. Furthermore, performances of microencapsulated products were obtained with a lower iron daily dose, limiting the potential onset of side effects.

Salivary cystatin SN is a factor predicting iron bioavailability after phytic acid rich meals in female participants

Phytic acid is an inhibitor of iron bioavailability, but it has been suggested that individuals may adapt to phytic acid over time, and that the salivary protein, cystatin SN, may be involved. This study evaluated the relationship between human cystatin SN levels and iron bioavailability after a phytic acid rich meal. Three groups of ten women consumed meals with: (1) 500 mg phytate sprinkles, (2) 500 mg phytate capsules, or (3) no phytic acid. Iron bioavailability was measured by the mealtime percentage of maximum iron recovery; cystatin SN was measured pre-and post-meal by enzyme-linked immunosorbent assay. Pre-to-post meal cystatin SN was positively correlated with improved iron bioavailability in group 1. Pre-to-post meal cystatin SN was correlated with improved iron absorption in groups 1 and 2. Cystatin SN recovery after phytic acid rich meals may be a physiological factor predicting iron bioavailability.

Quality Assessment of Cumin and Inulin Fortified Bakery Products and it’s &lt;i&gt;In Vitro&lt;/i&gt; Iron Bioavailability

Anemia is a worldwide deficiency that affects women and children. It can be overcome by adding iron in the diet by food fortification. The objective of the study was to improve iron bioavailability in bakery products by adding cumin and inulin. The physicochemical, nutritional and iron bioavailability properties of cumin and inulin fortified bakery products like breads, muffins, cookies and rusk were determined. The ash content analysis of cumin fortified bread was found to have higher mineral content in comparison to the other fortified bakery products. Among all the bakery products cumin fortification with inulin containing bread was found to have second higher iron bioavailability (0.7±0.004 mg/100 g). In the fortified bakery products, bread fortified with cumin and inulin was found to be better than the reference bread. Still in comparison to the reference bread fortified bread, organoleptic was found to be better. Therefore considering the iron bioavailability and relative overall acceptability, cumin fortified bread may be considered as one of the alternative for iron fortified products for preventing the iron deficiency anemia.