Abstract：
Hepcidin is secreted in inflammatory states as in patients on regular hemodialysis (HD). Therefore, novel agents modulating hepcidin secretion may have the potential to effectively reverse anemia in HD patients. Bovine milk derivative lactoferrin (BLF) is a glycoprotein that was found to decrease serum interleukin-6, therefore, having anti-inflammatory properties. Thus, it can downregulate hepcidin secretion in various inflammatory states including patients on regular HD, so improving iron absorption and utilization in those patients. In addition, BLF is a source of iron as each BLF molecule chelates two ferric ions. We started an interventional study. Seventy patients on regular HD with iron deficiency anemia received 100 mg of 20%-30% iron-saturated BLF (corresponding to 70-84 μg of elemental iron) orally b.i.d for 6 months. We compared those patients with another 70 patients on regular HD with iron deficiency anemia who were given 576 mg of ferrous glycine sulfate (corresponding to 100 mg of elemental iron) orally b.i.d for 6 months. BLF significantly decreased serum hepcidin level (from 340-350 ng/mL to 101-112 ng/mL), P <0.0001 and significantly increased hemoglobin (Hb) concentration (from 7.5-8.1 g/dL to 9.3-10 g/dL), P <0.0001, and transferrin saturation (TSAT) (from 5%-9% to 26%-31%), P <0.0001. Furthermore, ferrous glycine sulfate significantly decreased serum hepcidin level (from 335-350 ng/mL to 330--341 ng/mL), P <0.0001, and significantly increased Hb (from 7.5-8.1 to 7.6-8.5 g/dL), P <0.0001, and TSAT (from 5%-9% to 7%-12%), P <0.0001. However, the magnitude of decrease in serum hepcidin level and rise in Hb and TSAT in the BLF group was significantly higher than in the ferrous glycine sulfate group, P <0.0001. Oral BLF can be considered a promising novel agent in treatment of iron deficiency anemia in patients on regular HD.
摘要：
铁调素在炎症状态下分泌,如在常规血液透析(HD)的患者中。因此,调节铁调素分泌的新型药物可能具有有效逆转HD患者贫血的潜力。牛乳衍生物乳铁蛋白（BLF）是一种糖蛋白，被发现降低血清白细胞介素-6，因此，具有抗炎特性。因此，它可以下调各种炎症状态的铁调素分泌，包括定期HD患者，从而改善这些患者的铁吸收和利用。此外,BLF是铁的来源,因为每个BLF分子螯合两个三价铁离子。我们开始了一项介入研究。70例患有缺铁性贫血的常规HD患者口服b.i.d接受了100mg20％-30％铁饱和的BLF（相当于70-84μg元素铁），持续6个月。我们将这些患者与另外70例患有缺铁性贫血的常规HD患者进行了比较，这些患者口服b.i.d口服576mg硫酸甘氨酸亚铁（相当于100mg元素铁），持续6个月。BLF显着降低血清铁调素水平（从340-350ng/mL到101-112ng/mL），P<0.0001，血红蛋白（Hb）浓度显着增加（从7.5-8.1g/dL到9.3-10g/dL），P<0.0001，转铁蛋白饱和度（TSAT）（从5％-9％到26％-31％），P<0.0001。此外，硫酸亚铁甘氨酸显着降低血清铁调素水平（从335-350ng/mL到330-341ng/mL），P<0.0001，并且Hb显着增加（从7.5-8.1到7.6-8.5g/dL），P<0.0001，TSAT（从5%-9%到7%-12%），P<0.0001。然而,BLF组血清铁调素水平下降幅度和Hb和TSAT升高幅度明显高于硫酸甘氨酸亚铁组,P<0.0001。口服BLF可被认为是治疗常规HD患者缺铁性贫血的有前途的新型药物。
