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1.
Contrast Media Mol Imaging ; 2019: 7463047, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31598113

RESUMO

Aim: Iron overload is a life-threatening disorder that can increase the risks of cancer, cardiovascular disease, and liver cirrhosis. There is also a risk of iron overload in patients with chronic kidney disease. In patients with renal failure, iron storage is increased due to inadequate iron utilization associated with decreased erythropoiesis and also to the inflammatory status. To evade the risk of iron overload, an accurate and versatile indicator of body iron storage in patients with iron overload is needed. In this study, we aimed to find useful iron-related parameters that could accurately reflect body iron storage in mice in order to construct a murine model of iron overload. Methods: To select an appropriate indicator of body iron status, a variety of parameters involved in iron metabolism were evaluated. Noninvasively measured parameters were R1, R2, and R2 ∗ derived from magnetic resonance imaging (MRI). Invasively measured parameters included serum hepcidin levels, serum ferritin levels, and liver iron contents. Histopathological analysis was also conducted. Results/Conclusion: Among the several parameters evaluated, the MRI T2 ∗ relaxation time was able to detect iron storage in the liver as sensitively as serum ferritin levels. Moreover, it is expected that using an MRI parameter will allow accurate evaluation of body iron storage in mice over time.


Assuntos
Sobrecarga de Ferro/diagnóstico por imagem , Fígado/diagnóstico por imagem , Imageamento por Ressonância Magnética/estatística & dados numéricos , Animais , Modelos Animais de Doenças , Ferritinas/sangue , Hemoglobinas/análise , Hemossiderina/análise , Hepcidinas/sangue , Injeções Intraperitoneais , Ferro/análise , Sobrecarga de Ferro/metabolismo , Sobrecarga de Ferro/patologia , Complexo Ferro-Dextran/administração & dosagem , Complexo Ferro-Dextran/farmacocinética , Complexo Ferro-Dextran/toxicidade , Fígado/metabolismo , Fígado/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Organismos Livres de Patógenos Específicos , Tempo
2.
Regul Toxicol Pharmacol ; 94: 293-298, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29454888

RESUMO

Although parenteral iron products have been established to medicinal use decades before, their structure and pharmacokinetic properties are not fully characterized yet. With its' second reflection paper on intravenous iron-based nano-colloidal products (EMA/CHMP/SWP/620008/2012) the European Medicine Agency provided an extensive catalogue of methods for quality, non-clinical and pharmacokinetic studies for the comparison of nano-sized iron products to an originator (EMA, 2015). For iron distribution studies, the reflection paper assumed the use of rodents. In our tests, we used a turkey fetus model to investigate time dependent tissue concentrations in pharmacological and toxicological relevant tissues liver, heart and kidney. We found turkey embryos to be a suitable alternative to rodents with high discriminatory sensitivity. Clear differences were found between equimolar doses of iron products with hydroxyethyl amylopectin, sucrose, dextrane and carboxymaltose shell. A linear dose dependency for the tissue accumulation was also demonstrated.


Assuntos
Amilopectina/análogos & derivados , Amilopectina/farmacocinética , Embrião não Mamífero/metabolismo , Compostos Férricos/farmacocinética , Ácido Glucárico/farmacocinética , Complexo Ferro-Dextran/farmacocinética , Maltose/análogos & derivados , Nanopartículas , Amilopectina/administração & dosagem , Animais , Compostos Férricos/administração & dosagem , Óxido de Ferro Sacarado , Ácido Glucárico/administração & dosagem , Complexo Ferro-Dextran/administração & dosagem , Rim/metabolismo , Fígado/metabolismo , Maltose/administração & dosagem , Maltose/farmacocinética , Modelos Animais , Miocárdio/metabolismo , Nanopartículas/administração & dosagem , Equivalência Terapêutica , Turquia
3.
Toxicol Pathol ; 45(8): 1067-1076, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29020889

RESUMO

The hypothesis of this study is that the cerebral cortex, hippocampus, and striatum of the rat brain are differentially affected in terms of oxidative stress and antioxidant capacity by acute Fe overload because Fe is distributed in a heterogeneous fashion among different regions and cells of the brain. The effects on the lipophilic and hydrophilic cellular environment were compared between regions and with the whole brain. A single dose of Fe-dextran increased Fe deposits, reaching a maximum after 6 hr. Both in whole brain and in cortex region, the ascorbyl/ascorbate content ratio was increased after 6 hr of Fe administration, while in striatum and hippocampus, there was no significant changes after Fe overload. Total thiol content decreased in whole brain and cortex, while there were no significant changes in striatum and hippocampus after Fe overload. The content of α-tocopherol (α-T), whether measured in the whole brain or in the isolated regions, did not change following Fe treatment. Lipid radical (LR•) generation rate after Fe-dextran overload only increased in the cortex region. The LR•/α-T content ratio was increased by Fe treatment in cortex but not in the whole brain, striatum, or hippocampus, in agreement with the study tested hypothesis.


Assuntos
Antioxidantes/metabolismo , Encéfalo/metabolismo , Sobrecarga de Ferro/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Doença Aguda , Animais , Encéfalo/efeitos dos fármacos , Córtex Cerebral/efeitos dos fármacos , Córtex Cerebral/metabolismo , Corpo Estriado/efeitos dos fármacos , Corpo Estriado/metabolismo , Hipocampo/efeitos dos fármacos , Hipocampo/metabolismo , Complexo Ferro-Dextran/administração & dosagem , Complexo Ferro-Dextran/farmacocinética , Masculino , Ratos Sprague-Dawley , Distribuição Tecidual
4.
Biometals ; 27(2): 349-61, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24549594

RESUMO

Although iron is a first-line pro-oxidant that modulates clinical manifestations of various systemic diseases, including diabetes, the individual tissue damage generated by active oxidant insults has not been demonstrated in current animal models of diabetes. We tested the hypothesis that oxidative stress is involved in the severity of the tissues injury when iron supplementation is administered in a model of type 1 diabetes. Streptozotocin (Stz)-induced diabetic and non-diabetic Fischer rats were maintained with or without a treatment consisting of iron dextran ip at 0.1 mL day(-1) doses administered for 4 days at intervals of 5 days. After 3 weeks, an extensive increase (p < 0.001) in the production of reactive oxygen species (ROS) in neutrophils of the diabetic animals on iron overload was observed. Histological analysis revealed that this treatment also resulted in higher (p < 0.05) tissue iron deposits, a higher (p < 0.001) number of inflammatory cells in the pancreas, and apparent cardiac fibrosis, as shown by an increase (p < 0.05) in type III collagen levels, which result in dysfunctional myocardial. Carbonyl protein modification, a marker of oxidative stress, was consistently higher (p < 0.01) in the tissues of the iron-treated rats with diabetes. Moreover, a significant positive correlation was found between ROS production and iron pancreas stores (r = 0.42, p < 0.04), iron heart stores (r = 0.54, p < 0.04), and change of the carbonyl protein content in pancreas (r = 0.49, p < 0.009), and heart (r = 0.48, p < 0.02). A negative correlation was still found between ROS production and total glutathione content in pancreas (r = -0.50, p < 0.03) and heart (r = -0.45, p < 0.04). In conclusion, our results suggest that amplified toxicity in pancreatic and cardiac tissues in rats with diabetes on iron overload might be attributed to increased oxidative stress.


Assuntos
Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/patologia , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 1/patologia , Modelos Animais de Doenças , Complexo Ferro-Dextran/toxicidade , Estresse Oxidativo/efeitos dos fármacos , Animais , Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Tipo 1/induzido quimicamente , Sobrecarga de Ferro/induzido quimicamente , Sobrecarga de Ferro/complicações , Sobrecarga de Ferro/metabolismo , Complexo Ferro-Dextran/administração & dosagem , Complexo Ferro-Dextran/farmacocinética , Masculino , Ratos , Ratos Endogâmicos F344 , Espécies Reativas de Oxigênio/metabolismo , Estreptozocina , Distribuição Tecidual
5.
J Pharm Sci ; 102(3): 987-93, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23280725

RESUMO

Iron deficiency is one of the most prevalent and serious health issues among people all over the world. Iron-dextran (ID) colloidal solution is one among the very few US Food and Drug Administration (FDA)-approved iron sources for parenteral administration of iron. Parenteral route does not allow frequent administration because of its invasiveness and other associated complications. The main aim of this project was to investigate the plausibility of transdermal delivery of ID facilitated by microneedles, as an alternative to parenteral iron therapy. In vitro permeation studies were carried out using freshly excised hairless rat abdominal skin in a Franz diffusion apparatus. Iron repletion studies were carried out in hairless anemic rat model. The anemic rats were divided into intact skin (control), microneedle pretreated, and intraperitoneal (i.p.) groups depending on the mode of delivery of iron. The hematological parameters were measured intermittently during treatment. There was no improvement in the hematological parameters in case of control group, whereas, in case of microneedle pretreated and i.p. group, there was significant improvement within 2-3 weeks. The results suggest that microneedle-mediated delivery of ID could be developed as a potential treatment method for iron-deficiency anemia.


Assuntos
Anemia Ferropriva/tratamento farmacológico , Sistemas de Liberação de Medicamentos/instrumentação , Hematínicos/administração & dosagem , Hematínicos/farmacocinética , Complexo Ferro-Dextran/administração & dosagem , Complexo Ferro-Dextran/farmacocinética , Administração Cutânea , Anemia Ferropriva/sangue , Animais , Hematínicos/uso terapêutico , Infusões Parenterais , Complexo Ferro-Dextran/uso terapêutico , Masculino , Ratos , Ratos Pelados , Pele/metabolismo , Absorção Cutânea
6.
Med Oncol ; 26(1): 105-15, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-18473194

RESUMO

UNLABELLED: Cancer-related anemia is common and multifactorial in origin. Functional iron deficiency (FID) is now recognized as a cause of iron-restricted erythropoiesis and may be one of the major reasons for lack of response to treatment with Erythropoietic Stimulating Agents (ESAs). Numerous studies have shown that intravenous (IV), but not oral, iron therapy effectively provides sufficient iron for optimal erythropoiesis in anemic patients with chronic renal disease receiving ESA therapy. The use of IV iron has also been suggested in the cancer setting. Six recent studies have tested this assumption and are summarized in this review. Four formulations of IV iron are available in Europe, with different pharmacokinetics, iron bioavailability, and risk of acute adverse drug reactions. CONCLUSION: Limited iron stores and FID are common causes of response failure during ESA treatment in cancer patients and should be diagnosed. There is now substantial scientific support for the use of IV iron supplementation to improve response and this has been acknowledged in international and national guidelines. Prospective long-term data on the safety of IV iron in this setting are still awaited. Recommendations concerning the optimal formulation, doses, and schedule of iron supplementation to ESA treatment in cancer-related anemia are provisional awaiting data from prospective, randomized trials.


Assuntos
Anemia Ferropriva , Hematínicos/administração & dosagem , Compostos de Ferro/administração & dosagem , Neoplasias/complicações , Administração Oral , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/etiologia , Esquema de Medicação , Eritropoese/efeitos dos fármacos , Compostos Férricos/administração & dosagem , Compostos Férricos/efeitos adversos , Compostos Férricos/farmacocinética , Óxido de Ferro Sacarado , Compostos Ferrosos/administração & dosagem , Compostos Ferrosos/efeitos adversos , Compostos Ferrosos/farmacocinética , Ácido Glucárico , Hematínicos/efeitos adversos , Hematínicos/farmacocinética , Humanos , Infusões Intravenosas , Compostos de Ferro/efeitos adversos , Compostos de Ferro/farmacocinética , Ferro da Dieta/administração & dosagem , Ferro da Dieta/efeitos adversos , Ferro da Dieta/farmacocinética , Complexo Ferro-Dextran/administração & dosagem , Complexo Ferro-Dextran/efeitos adversos , Complexo Ferro-Dextran/farmacocinética , Maltose/administração & dosagem , Maltose/efeitos adversos , Maltose/análogos & derivados , Maltose/farmacocinética , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
Transl Res ; 151(1): 36-44, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18061126

RESUMO

In this study the toxicity and intracellular availability of iron from iron dextran (FeD), iron sucrose (FeS), and iron gluconate (FeG) was compared in organs of avian (turkey) embryos and in isolated cells (HepG2) in cell culture. Iron uptake was more pronounced in embryonic liver than in renal tissue. Cellular iron uptake in liver and kidney was more or less similar for the different compounds. Only some experiments showed slightly greater iron concentrations in liver and kidney with FeG compared with FeD and FeS. Significant differences were found in the survival ratios of the eggs and the embryo weights depending on the type of iron complex administered. The rank order of toxicities was FeG>FeS>FeD. Iron accumulation in HepG2-cells was extremely high with FeS and FeG, whereas FeD did not lead to a relevant iron uptake by HepG2 cells. The excessively high iron content of the cells is an in vitro phenomenon found neither in the in ovo model with the turkey embryos nor in the clinical use of the compounds. The rank order of toxicities in HepG2 cells was FeS>FeG>FeD. Iron uptake in cell culture does not reflect the in vivo situation. The in ovo model is more suitable to assess the cellular iron uptake and iron toxicity in cells and tissues than the in vitro model. In both in ovo and in vitro experiments, FeD seemed to be superior in terms of toxicity.


Assuntos
Embrião não Mamífero/efeitos dos fármacos , Compostos Férricos/toxicidade , Hematínicos/toxicidade , Complexo Ferro-Dextran/toxicidade , Fígado/citologia , Animais , Peso Corporal/efeitos dos fármacos , Carcinoma Hepatocelular , Linhagem Celular Tumoral , Embrião de Galinha , Compostos Férricos/farmacocinética , Óxido de Ferro Sacarado , Ácido Glucárico , Gluconatos/farmacocinética , Gluconatos/toxicidade , Hematínicos/farmacocinética , Humanos , Complexo Ferro-Dextran/farmacocinética , Rim/efeitos dos fármacos , Rim/metabolismo , Fígado/efeitos dos fármacos , Fígado/metabolismo , Neoplasias Hepáticas , Nanopartículas , Taxa de Sobrevida , Perus
8.
Acta Haematol ; 118(4): 193-9, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17940334

RESUMO

INTRODUCTION: Iron cardiomyopathy is a lethal complication of transfusion therapy in thalassemia major. Nutritional supplements decreasing cardiac iron uptake or toxicity would have clinical significance. Murine studies suggest taurine may prevent oxidative damage and inhibit Ca2+-channel-mediated iron transport. We hypothesized that taurine supplementation would decrease cardiac iron-overloaded toxicity by decreasing cardiac iron. Vitamin E and selenium served as antioxidant control. METHODS: Animals were divided into control, iron, taurine, and vitamin E/selenium groups. Following sacrifice, iron and selenium measurements, histology, and biochemical analyses were performed. RESULTS: No significant differences were found in heart and liver iron content between treatment groups, except for higher hepatic dry-weight iron concentrations in taurine-treated animals (p < 0.03). Serum iron increased with iron loading (751 +/- 66 vs. 251 +/- 54 microg/dl, p < 0.001) and with taurine (903 +/- 136 microg/dl, p = 0.03). CONCLUSION: Consistent with oxidative stress, iron overload increased cardiac malondialdehyde levels, decreased heart glutathione peroxidase (GPx) activity, and increased serum aspartate aminotransferase. Taurine ameliorated these changes, but only significantly for liver GPx activity. Selenium and vitamin E supplementation did not improve oxidative markers and worsened cardiac GPx activity. These results suggest that taurine acts primarily as an antioxidant rather than inhibiting iron uptake. Future studies should illuminate the complexity of these results.


Assuntos
Antioxidantes/uso terapêutico , Cardiomiopatias/prevenção & controle , Sobrecarga de Ferro/tratamento farmacológico , Miocárdio/metabolismo , Taurina/uso terapêutico , Alanina Transaminase/sangue , Animais , Antioxidantes/administração & dosagem , Aspartato Aminotransferases/sangue , Cardiomiopatias/etiologia , Avaliação Pré-Clínica de Medicamentos , Feminino , Gerbillinae , Glutationa Peroxidase/análise , Coração/efeitos dos fármacos , Sobrecarga de Ferro/complicações , Complexo Ferro-Dextran/farmacocinética , Complexo Ferro-Dextran/toxicidade , Peroxidação de Lipídeos/efeitos dos fármacos , Fígado/química , Fígado/efeitos dos fármacos , Fígado/enzimologia , Fígado/patologia , Malondialdeído/análise , Modelos Animais , Miocárdio/química , Miocárdio/patologia , Tamanho do Órgão/efeitos dos fármacos , Estresse Oxidativo , Ácido Selênico , Compostos de Selênio/administração & dosagem , Compostos de Selênio/uso terapêutico , Taurina/administração & dosagem , Vitamina E/administração & dosagem , Vitamina E/uso terapêutico
9.
J Med Chem ; 49(24): 7032-43, 2006 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-17125256

RESUMO

A series of iron chelators, three (S)-4,5-dihydro-2-(2-hydroxyphenyl)-4-methyl-4-thiazolecarboxylic acid (DADFT) and three (S)-4,5-dihydro-2-(2-hydroxyphenyl)-4-thiazolecarboxylic acid (DADMDFT) analogues are synthesized and assessed for their lipophilicity (log Papp), iron-clearing efficiency (ICE) in rodents and iron-loaded primates (Cebus apella), toxicity in rodents, and organ distribution in rodents. The results lead to a number of generalizations useful in chelator design strategies. In rodents, while log Papp is a good predictor of a chelator's ICE, chelator liver concentration is a better tool. In primates, log Papp is a good predictor of ICE, but only when comparing structurally very similar chelators. There is a profound difference in toxicity between the DADMDFT and DADFT series: DADMDFTs are less toxic. Within the DADFT family of ligands, the more lipophilic ligands are generally more toxic. Lipophilicity can have a profound effect on ligand organ distribution, and ligands can thus be targeted to organs compromised in iron overload disease, for example, the heart.


Assuntos
Ácidos Carboxílicos/síntese química , Quelantes de Ferro/síntese química , Tiazóis/síntese química , Animais , Bile/metabolismo , Ácidos Carboxílicos/química , Ácidos Carboxílicos/farmacologia , Cebus , Di-Hidropiridinas/síntese química , Di-Hidropiridinas/química , Di-Hidropiridinas/farmacologia , Quelantes de Ferro/química , Quelantes de Ferro/farmacologia , Complexo Ferro-Dextran/sangue , Complexo Ferro-Dextran/farmacocinética , Complexo Ferro-Dextran/urina , Rim/metabolismo , Fígado/metabolismo , Masculino , Miocárdio/metabolismo , Especificidade de Órgãos , Pâncreas/metabolismo , Ratos , Ratos Sprague-Dawley , Estereoisomerismo , Relação Estrutura-Atividade , Tiazóis/química , Tiazóis/farmacologia , Distribuição Tecidual
10.
Kidney Int ; 66(3): 1139-44, 2004 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-15327409

RESUMO

BACKGROUND: Iron deficiency anemia in chronic kidney disease is commonly treated with one of three intravenous irons-iron dextran, iron sucrose, or iron gluconate. Substantial pharmacologic differences between drugs exist, but their ability to saturate transferrin has not been compared. Drugs that may lead to rapid transferrin saturation may lead to greater efficacy but also increased toxicity if transferring-mediated uptake of iron is the basis of this toxicity. METHODS: We studied the in vitro ability of the three intravenous irons to donate iron to transferrin. Transferrin saturation was studied by direct visualization of the transferrin bands by urea polyacrylamide gel electrophoresis (PAGE), as well as a functional assay that evaluated the ability of iron to half saturate transferrin in a dose-dependent (0 to 100 microg/mL) and time-dependent (15 to 180 min) manner. Half-maximal dose (EC(50)) of iron needed to saturate transferrin was evaluated. RESULTS: Nondextran irons were able to saturate transferrin in a dose-dependent and time-dependent manner. There was more rapid transferrin saturation with iron gluconate compared to iron sucrose. The slope of the EC(50) versus dose iron gluconate titration curve was -0.021 nmol/microg/mL (95% CI -0.025 to -0.017, P < 0.0001), for iron sucrose -0.006 nmol/microg/mL (95% CI -0.010 to -0.002, P= 0.002), and for iron dextran -0.001 nmol/microg/mL (95% CI -0.004 to 0.003, P > 0.2). The least square mean EC(50) computed for mean iron concentration was 5.95 nmol for iron gluconate (95% CI 5.82 to 6.08), 6.73 nmol for iron sucrose (95% CI 6.59 to 6.86), and 7.24 nmol for iron dextran (95% CI 7.11 to 7.38). Similar results were seen for the time-dependent transferrin saturation (drug x time interaction, F 6.0, P < 0.01). Urea PAGE analysis showed similar results as the functional assay. CONCLUSION: Substantial heterogeneity in direct iron transfer from iron pharmaceuticals in vitro suggests that differences may exist in safety and efficacy of these drugs in vivo. In vivo studies are needed to compare the safety and efficacy of existing nondextran parenteral irons to better define the therapeutic ratio.


Assuntos
Compostos Férricos/farmacocinética , Ferro/farmacocinética , Transferrina/metabolismo , Óxido de Ferro Sacarado , Ácido Glucárico , Humanos , Técnicas In Vitro , Infusões Intravenosas , Complexo Ferro-Dextran/farmacocinética , Titulometria
11.
J Pharm Sci ; 93(7): 1838-46, 2004 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15176071

RESUMO

The first iron-dextran complex was discovered in 1953, when we attempted to synthesize an analog of ferritin, by substituting polysaccharide for its protein shell. This new complex soon became the most widely used parental therapy for hypochromic anemia in humans. No molecular formula has been proposed, but Cox has attributed an outline structure to it. The present article proposes a structure greatly different from the Cox model, by having a polynuclear beta-ferric oxyhydroxide core, closely similar or identical to Akaganeite, chelated firmly by an encircling framework of dextran gluconic acid chains and surrounded by a removable outer sheath of colloidal dextran gluconic acid. The molecular weight of the iron-dextran core molecule, including its chelated framework, has been determined by gel filtration and analysis and its molecular formula (1.3) calculated. Also, these new data and existing electron photomicrographic, X-ray diffraction and crystallographic studies, have enabled a molecular weight, formula, and model structure to be proposed for its complex (2), which includes the outer sheath. The 480 iron atoms in both the core molecule and its sheathed complex are close to the number calculated from the core's unit cell dimensions and volume.


Assuntos
Complexo Ferro-Dextran/análise , Complexo Ferro-Dextran/química , Química Farmacêutica , Complexo Ferro-Dextran/farmacocinética , Estrutura Molecular
12.
Sleep Med ; 5(3): 231-5, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15165528

RESUMO

BACKGROUND AND PURPOSE: To evaluate the safety and efficacy of a single 1000 mg iron infusion in treating Restless Legs Syndrome (RLS). PATIENTS AND METHODS: A single 1000 mg intravenous (IV) [Am J Med Sci 31 (1999) 213] infusion of iron dextran was evaluated in an open-label study. Primary outcomes of efficacy were symptom severity assessed by global rating scale and periodic leg movements in sleep (PLMS) at 2 weeks post-infusion. Secondary outcomes included total sleep time (TST), hours/day of RLS symptoms, and changes in magnetic resonance imaging (MRI)-determined iron concentrations in the substantia nigra. Primary safety measures were reported adverse events and monthly serum ferritin levels. RESULTS: IV iron therapy significantly improved the mean global RLS symptom severity, TST, hours with RLS symptoms and PLMS, but on an individual basis failed to produce any response in 3 of the 10 subjects who were fully treated. Brian iron concentrations at 2 weeks post-infusion as determined by MRI were increased in the substantia nigra and prefrontal cortex. Serum ferritin levels showed a greater than predicted rapid linear decrease. Side effects were mild, except in one subject who developed an acute allergic reaction. CONCLUSIONS: The results in this study provide valuable information for future studies, but the efficacy and safety of IV iron treatment for RLS remain to be established in double-blind studies. The serum ferritin results suggest that greater than expected iron loss occurs after IV iron loading.


Assuntos
Encéfalo/anatomia & histologia , Complexo Ferro-Dextran/uso terapêutico , Síndrome das Pernas Inquietas/tratamento farmacológico , Idoso , Encéfalo/metabolismo , Feminino , Ferritinas/sangue , Humanos , Injeções Intravenosas , Complexo Ferro-Dextran/administração & dosagem , Complexo Ferro-Dextran/farmacocinética , Masculino , Pessoa de Meia-Idade , Córtex Pré-Frontal/anatomia & histologia , Córtex Pré-Frontal/metabolismo , Síndrome das Pernas Inquietas/diagnóstico , Índice de Gravidade de Doença , Substância Negra/anatomia & histologia , Substância Negra/metabolismo
13.
Am J Obstet Gynecol ; 189(4): 958-62, 2003 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-14586334

RESUMO

OBJECTIVE: We hypothesized that normal fetal breathing, not acute asphyxial gasping, results in the movement of iron dextran from the amniotic cavity into the fetal lungs. In addition, the amount of iron dextran moving into the fetal lungs is cumulative with time. STUDY DESIGN: Twelve pregnant New Zealand White rabbits at 25 days of gestation were sedated and underwent ultrasound-guided injections of iron dextran into the amniotic cavities of the rabbit fetuses in both horns of each pregnant doe. Oxygen saturation was maintained at >90% in the pregnant does. The 12 does were then equally assigned to four groups on the basis of the duration of fetal exposure to the dextran (0, 8, 16, and 24 hours). At the end of each time point, one half of the fetuses received an intracardiac injection of potassium chloride to induce gasping just before necropsy. Gasping was confirmed by ultrasound scanning. At necropsy, the fetal lungs were evaluated grossly and underwent histomorphometry for iron distribution and quantification in the fetal airways. RESULTS: In the animals that received iron dextran, there was no significant difference in iron accumulation at any time point between those animals that did and did not receive potassium chloride, which suggests that acute gasping does not increase the accumulation of amniotic fluid substances in the lungs. The amount of iron in the fetal airways increased significantly with progressive length of exposure. CONCLUSION: We conclude that normal fetal breathing, not acute asphyxial gasping, resulted in the movement of intra-amniotic iron dextran into the fetal lungs and that the amount of substances that move into the fetal lungs accumulated with time.


Assuntos
Asfixia/metabolismo , Doenças Fetais/metabolismo , Feto/fisiologia , Complexo Ferro-Dextran/farmacocinética , Pulmão/metabolismo , Líquido Amniótico , Animais , Feminino , Feto/metabolismo , Complexo Ferro-Dextran/administração & dosagem , Cloreto de Potássio , Gravidez , Coelhos
15.
Blood ; 93(1): 370-5, 1999 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-9864183

RESUMO

To further examine the potential clinical usefulness of the hexadentate phenolic aminocarboxylate iron chelator N, N'-bis(2-hydroxybenzyl)ethylenediamine-N,N'-diacetic acid (HBED) for the chronic treatment of transfusional iron overload, we performed a subchronic toxicity study of the HBED monosodium salt in rodents and have evaluated the iron excretion in primates induced by HBED. The HBED-induced iron excretion was determined for the monohydrochloride dihydrate that was first dissolved in a 0.1-mmol/L sodium phosphate buffer at pH 7.6 and administered to the primates either orally (PO) at a dose of 324 micromol/kg (149.3 mg/kg, n = 5), subcutaneously (sc) at a dose of 81 micromol/kg (37.3 mg/kg, n = 5), sc at 324 micromol/kg (n = 5), and sc at 162 micromol/kg (74.7 mg/kg) for 2 consecutive days for a total dose of 324 micromol/kg (n = 3). In addition, the monosodium salt of HBED in saline was administered to the monkeys sc at a single dose of 150 micromol/kg (64.9 mg/kg, n = 5) or at a dose of 75 micromol/kg every other day for three doses, for a total dose of 225 micromol/kg (n = 4). For comparative purposes, we have also administered deferoxamine (DFO) PO and sc in aqueous solution at a dose of 300 micromol/kg (200 mg/kg). In the iron-loaded Cebus apella monkey, whereas the PO administration of DFO or HBED even at a dose of 300 to 324 micromol/kg was ineffective, the sc injection of HBED in buffer or its monosodium salt, 75 to 324 micromol/kg, produced a net iron excretion that was nearly three times that observed after similar doses of sc DFO. In patients with transfusional iron overload, sc injections of HBED may provide a much needed alternative to the use of prolonged parenteral infusions of DFO. Note: After the publication of our previous paper (Blood, 91:1446, 1998) and the completion of the studies described here, it was discovered that the HBED obtained from Strem Chemical Co (Newburyport, MA) that was labeled and sold as a dihydrochloride dihydrate was in fact the monohydrochloride dihydrate. Therefore, the actual administered doses were 81, 162, or 324 micromol/kg; not 75, 150, or 300 micromol/kg as was previously reported. The new data have been recalculated accordingly, and the data from our earlier study, corrected where applicable, are shown in parentheses.


Assuntos
Desferroxamina/toxicidade , Ácido Edético/análogos & derivados , Quelantes de Ferro/toxicidade , Administração Oral , Animais , Cebus , Desferroxamina/farmacocinética , Ácido Edético/farmacocinética , Ácido Edético/toxicidade , Injeções Intravenosas , Injeções Subcutâneas , Ferro/metabolismo , Ferro/urina , Quelantes de Ferro/farmacocinética , Sobrecarga de Ferro/tratamento farmacológico , Sobrecarga de Ferro/metabolismo , Complexo Ferro-Dextran/farmacocinética , Complexo Ferro-Dextran/toxicidade , Masculino , Ratos , Ratos Sprague-Dawley
16.
Am J Obstet Gynecol ; 177(1): 42-9, 1997 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-9240581

RESUMO

OBJECTIVE: Whether fetal breathing movements or gasping result in the movement of amniotic fluid substances into the distal airways remains controversial. We evaluated the effect of paralysis of the preterm rabbit fetus on the pulmonary distribution of iron dextran. STUDY DESIGN: Laparotomy was performed on 10 New Zealand White rabbits of 25 days' gestation (term 31 days) under general anesthesia. Fetuses in one uterine horn were given an intramuscular injection of pancuronium (1.5 mg/kg) and fetuses in the other horn were given an equal volume of normal saline solution as controls. A 1 ml volume of iron dextran (100 mg/ml) was injected into the amniotic sac of all fetuses. The laparotomy was closed, and 20 to 24 hours later the fetuses were removed by hysterotomy and assessed for paralysis. Necropsy was performed. Lungs were stained with prussian blue and evaluated histologically for the presence of iron. RESULTS: A total of 92 pups were delivered (49 given pancuronium, 43 given normal saline solution), of which 64 were born alive. There were no differences between groups for live births (31 pancuronium, 33 normal saline solution), pup body weight, or lung weight. Pups given normal saline solution demonstrated more breathing motions, spontaneous movement, and brown (color of iron dextran) stomach contents than did the pups given pancuronium (p < 0.001). At necropsy a greater number of control pups (31/33) had brown lungs grossly compared with pups given pancuronium (2/31, p < 0.001). Lung histologic examination showed that more control pups (29/29) had iron in the trachea and main bronchi compared with pancuronium pups (0/27, p < 0.001), and more control pups (29/29) had iron in the distal lung airways compared with pancuronium pups (0/27, p < 0.001). With use of the Optimas Image Analysis System, iron in the lungs of control pups was found to be equally distributed between right versus left lungs, upper half versus lower half lungs, and anterior versus posterior lung sections. More iron was identified in the central airways than in the periphery (p < 0.001). CONCLUSION: We conclude that paralysis prevents the uptake of iron dextran into the main and distal airways of the rabbit fetus. Although lung fluid production results in a net efflux of fluid, we speculate that fetal breathing movements can result in the movement of fluid into distal airways and potentially provide fetal therapy.


Assuntos
Líquido Amniótico/metabolismo , Doenças Fetais/metabolismo , Complexo Ferro-Dextran/farmacocinética , Pulmão/metabolismo , Paralisia/metabolismo , Respiração/fisiologia , Líquido Amniótico/química , Animais , Transporte Biológico , Peso Corporal/fisiologia , Feminino , Doenças Fetais/induzido quimicamente , Doenças Fetais/fisiopatologia , Movimento Fetal/fisiologia , Feto/metabolismo , Feto/fisiopatologia , Injeções Intramusculares , Complexo Ferro-Dextran/administração & dosagem , Complexo Ferro-Dextran/análise , Pulmão/embriologia , Pulmão/fisiologia , Fármacos Neuromusculares Despolarizantes/administração & dosagem , Fármacos Neuromusculares Despolarizantes/efeitos adversos , Trabalho de Parto Prematuro/fisiopatologia , Tamanho do Órgão , Pancurônio/administração & dosagem , Pancurônio/efeitos adversos , Paralisia/induzido quimicamente , Paralisia/fisiopatologia , Projetos Piloto , Gravidez , Coelhos/embriologia , Coelhos/metabolismo , Coelhos/fisiologia
17.
J Toxicol Environ Health ; 51(3): 235-44, 1997 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-9183380

RESUMO

The present study was undertaken to investigate the effect of iron dextran treatment on polyamine oxidase (PAO) activity, iron accumulation, and lipid peroxidation in livers and hearts of rats. PAO catalyzes oxidative deamination of polyamines, the cellular aliphatic cations. This reaction produces highly toxic hydrogen peroxide, 3-acetamidopropanal, and precursors of higher polyamines. The rats were given iron dextran daily for 7 d. In iron-dextran-treated rats, a marked increase in the hepatic level of iron was associated with enhanced lipid peroxidation and increased PAO activity. Though iron accumulation and lipid peroxidation in the iron-treated rats increased significantly in the heart, PAO activity remained unchanged. The paraffin sections of livers stained with Perls iron stain showed the presence of iron in macrophages and hepatocytes. The sections of hearts showed iron deposits only in macrophages, while myocytes showed no iron staining. These results show that although iron dextran treatment results in accumulation of iron in both liver and heart, it induces PAO activity only in liver. The significance of increased PAO activity in lipid peroxidation and fibrosis in iron-mediated injury is discussed.


Assuntos
Sobrecarga de Ferro/enzimologia , Fígado/enzimologia , Miocárdio/enzimologia , Oxirredutases atuantes sobre Doadores de Grupo CH-NH/biossíntese , Animais , Indução Enzimática/efeitos dos fármacos , Coração/efeitos dos fármacos , Hematínicos/administração & dosagem , Hematínicos/farmacocinética , Hematínicos/toxicidade , Injeções Intraperitoneais , Ferro/metabolismo , Sobrecarga de Ferro/patologia , Complexo Ferro-Dextran/administração & dosagem , Complexo Ferro-Dextran/farmacocinética , Complexo Ferro-Dextran/toxicidade , Peroxidação de Lipídeos/efeitos dos fármacos , Fígado/efeitos dos fármacos , Masculino , Ornitina Descarboxilase/biossíntese , Poliaminas/metabolismo , Ratos , Ratos Sprague-Dawley , Poliamina Oxidase
18.
Adv Perit Dial ; 11: 57-9, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-8534738

RESUMO

We investigated the absorption rate and acute toxicities of intraperitoneal iron dextran in rats. Eighteen Sprague-Dawley rats were divided into three groups (n = 6). The animals were given standard 1.5% Dianeal (group 1) or 1.5% Dianeal containing iron in a concentration of 2 mg/L (group 2) or 10 mg/L (group 3) as iron dextran. First, a predialysis blood sample was obtained, and 25 mL of the designated dialysis solution was instilled into the peritoneal cavity. After a 6-hour cycle the dialysate was drained, and a postdialysis blood sample and specimen of the peritoneum were obtained. The iron concentrations of the dialysis solution, the dialysate, and both serum samples were determined. Histological samples were processed by hematoxylin and eosin and Prussian blue stain. Results of the iron concentration (mg/L) of the dialysis solution, the dialysate, and the percent of the absorbed iron were as follows: group 1: 0.00, 0.20 +/- 0.15, N/A; group 2: 2.24, 0.66 +/- 2.8, 73.8 +/- 11.0; group 3: 9.84, 2.12 +/- 0.62, 80.8 +/- 5.7. The serum iron concentration did not change. No abnormal findings were found histologically. More than 70% of the iron dextran was absorbed from the peritoneal cavity of the rats during a 6-hour peritoneal dialysis exchange. Intraperitoneal iron dextran may be an alternative route of iron delivery.


Assuntos
Complexo Ferro-Dextran/administração & dosagem , Complexo Ferro-Dextran/farmacocinética , Diálise Peritoneal , Absorção , Animais , Ferro/sangue , Complexo Ferro-Dextran/toxicidade , Masculino , Cavidade Peritoneal , Peritônio/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley
19.
Toxicol Pathol ; 21(3): 311-20, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-8248720

RESUMO

We have developed a guinea pig model of iron overload toxicity. Animals were administered intraperitoneal iron dextran 3 times a week to achieve total body iron load of 0.25, 0.5, 1.0, 1.5, and 2.0 g Fe/kg body weight in less than 30 days. Quantitation of tissue iron levels with atomic absorption indicated increased iron deposition in liver and heart of the iron-loaded guinea pigs (p < 0.001). Additionally, the iron-loaded pigs demonstrated decreased nuclear magnetic resonance spectroscopy T1 relaxation times in both liver and heart (p < 0.001). Serum iron, total body iron capacity, and transferrin saturation values were also determined in guinea pigs treated with 0.25, 0.5, and 1.0 g Fe/kg body weight. Serum iron and total iron-binding capacity were significantly increased at 0.5 and 1.0 g Fe/kg; transferrin saturation was elevated at 0.25 and 1.0 g Fe/kg. kg. Histologic examination of liver, heart, and bone marrow as well as ultrastructural studies on liver and heart confirmed increased iron deposition in treated animals. At the low iron dose level of 0.5 g Fe/kg, liver iron particles were primarily confined to Kupffer cells with minimal hepatocellular localization. Increased hepatocellular iron deposition was observed with larger doses of loaded iron. Myocardial iron was most prominent in interstitial cells of the epicardium, endocardium, myocardium, and coronary adipose tissue. Ultrastructurally, the presence of iron particles in perinuclear, membrane-bound structures (consistent with lysosomes) was confirmed using x-ray microanalysis. These morphological studies suggest that in this animal model siderosis of hepatic mononuclear phagocyte and myocardial interstitial cells may be the initial lesions leading to further biochemical and functional abnormalities. Correlation between tissue iron measurements and both light and electron microscopic changes, presented in this report, serve to introduce the iron-loaded guinea pig as a model for the study of iron-induced tissue damage.


Assuntos
Complexo Ferro-Dextran/toxicidade , Animais , Medula Óssea/metabolismo , Modelos Animais de Doenças , Microanálise por Sonda Eletrônica , Feminino , Cobaias , Ferro/sangue , Ferro/farmacocinética , Complexo Ferro-Dextran/farmacocinética , Fígado/metabolismo , Fígado/patologia , Espectroscopia de Ressonância Magnética , Miocárdio/metabolismo , Miocárdio/patologia , Espectrofotometria Atômica , Transferrina/metabolismo
20.
Arch Med Res ; 23(1): 7-11, 1992.
Artigo em Inglês | MEDLINE | ID: mdl-1308796

RESUMO

Rabbits subjected to a daily bloodletting schedule of 10 ml blood per kg body weight increase four- or fivefold their erythropoietic production compared to normal non-bled animals. The maximum response they can reach under these conditions mobilizes more than 9 mg of iron per day per rabbit into hemoglobin. When fed ad libitum with their regular diet, they do not need any further iron supplement for full erythropoiesis. The experimental increment in iron body stores and/or serum iron levels does not enhance their erythropoietic response, demonstrating that iron is not rate limiting under the conditions studied. Furthermore, although serum iron levels are elevated onefold in the controls under chronic anemia with respect to non-bled animals, the concentration of serum transferrin is only slightly increased; hence, the iron saturation of this protein changes from a 50% to an 80% level. In the absence of an extra supplement of iron, rabbits subjected to chronic bloodletting show no signs of body iron depletion, as judged by their continuous macrocytic RBC production.


Assuntos
Anemia/fisiopatologia , Eritropoese , Ferro/metabolismo , Coelhos/metabolismo , Anemia/tratamento farmacológico , Anemia/etiologia , Anemia/metabolismo , Animais , Transporte Biológico , Sangria/efeitos adversos , Índices de Eritrócitos/efeitos dos fármacos , Feminino , Hemoglobinas/metabolismo , Injeções Intraperitoneais , Complexo Ferro-Dextran/administração & dosagem , Complexo Ferro-Dextran/farmacocinética , Complexo Ferro-Dextran/uso terapêutico , Masculino , Transferrina/análise
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