Iron in medicine and treatment

• Autorzy: Luchowska-Kocot D.

Warianty tytułu

PL

Żelazo w medycynie i lecznictwie

• Języki publikacji: EN

Abstrakty

EN

Being a component of many proteins and enzymes, iron is an essential microelement for humans. However, this element can also be toxic when present in excess because of its ability to generate reactive oxygen species. This dual nature imposes a strict regulation mechanism of the iron concentration in the body. In humans, systemic iron homeostasis is mainly regulated on the level of intestinal absorption. A patient diagnosed with excess iron in the body should be treated safely and effectively. And the therapy should be consistent with the treatment of concurrent diseases. On the other hand, iron deficiency is one of the most common disorders affecting humans. Iron-deficiency anaemia continues to represent a major public health problem worldwide, being prevalent among pregnant women, where it represents an important risk factor for maternal and infant health. A problem detecetd relatively recently and therefore not fully clarified yet is the iron therapy in patients with restless legs syndrome (RLS). RLS is a common neurological condition defined clinically as the urge to move the legs. Reduced brain iron is strongly associated with restless legs syndrome. RLS can also be a consequence of iron deficiency in the body. This review will focus on iron as an element whose abnormal metabolism or deficiency in the body can lead to diseases e.g. anaemia, restless legs syndrome and iron overload. Here we will describe methods of therapy, paying particular attention to the types and dosages of medications.

PL

Żelazo jest podstawowym mikroelementem organizmu ludzkiego, stanowi bowiem istotny element wielu białek i enzymów. Jednak pierwiastek ten może wykazywać działanie toksyczne, gdy występuje w nadmiarze, ze względu na jego zdolność do generowania reaktywnych form tlenu. Ten podwójny charakter żelaza narzuca ścisłą regulację stężenia żelaza w organizmie. U ludzi homeostaza ustrojowa żelaza jest głównie regulowana na poziomie wchłaniania jelitowego. Pacjent, u którego zdiagnozowano nadmiar żelaza w organizmie, powinien być poddany bezpiecznemu i skutecznemu leczeniu, które jest zgodne z terapią współistniejących schorzeń. Niedobór żelaza jest jednym z najczęstszych zaburzeń dotykających ludzi. Niedokrwistość spowodowana niedoborem żelaza nadal stanowi istotny problem zdrowia publicznego na całym świecie. Szczególnie dotyczy kobiet w ciąży, stanowiąc istotny czynnik ryzyka dla zdrowia matki i dziecka. Stosunkowo nowym i nie do końca wyjaśnionym zagadnieniem jest terapia żelazem chorych na zespół niespokojnych nóg (RLS). Jest to stan neurologiczny klinicznie określany jako przymus poruszania nogami. Z zespołem niespokojnych nóg związana jest ściśle redukcja żelaza w mózgu. RLS może być również konsekwencją niedoboru żelaza w organizmie. W pracy omówiono nieprawidłowy metabolizm żelaza lub jego brak w organizmie, co może prowadzić do ww. jednostek chorobowych. Opisano również metody terapii, zwracając szczególną uwagę na rodzaj i wielkość dawki proponowanych leków.

Słowa kluczowe

EN

iron; medicine; treatment; iron deficiency; anaemia; restless legs syndrome; Willis-Ekbom disease zob.restless legs syndrome; Wittmaack-Ekbom syndrome zob.restless legs syndrome; pregnancy

• Wydawca: -
• Czasopismo: Journal of Elementology
• Rocznik: 2014
• Tom: 19
• Numer: 3
• Opis fizyczny: p.889-901,ref.

Twórcy

autor

Luchowska-Kocot D.

• Chair and Department of Medical Chemistry, Medical University of Lublin, Chodzki 4a, 20-093 Lublin, Poland

Bibliografia

• Allen R.P., Picchietti D., Hening W.A., Trenkwalder C., Walters A.S., Montpl aisi J. 2003. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med., 4(2):101-19.
• Alleyne M., Horne McD. K., Mill er J. L. 2009. Individualized treatment for iron-deficiency anemia in adults. Am. J. Med., 121: 943-948.
• Anderson G.J., Darshan D., Wilkins S.J., Frazer D.M. 2006. Regulation of systemic iron homeostasis: how the body responds to changes in iron demand. Biometals, 20: 665-674.
• Andrews N.C. 1999. Disorders of iron metabolism. N Engl J Med., 341:1986-95.
• Auerbach M., Ballard H., Glaspy J. 2007. Clinical update: intravenous iron for anaemia. The Lancet, 369: 1502-1504.
• Barton J.C. 2007. Chelation therapy for iron overload. Curr Gastroenterol Rep, 9: 74-82.
• Barton J.C. 2008. Deferasirox Novartis. Curr. Opin. Investig. Drugs, 6: 327-335.
• Camaschell a C., Strati P. 2010. Recent advances in iron metabolism and related disorders. Intern Emerg., 5: 393-400.
• Beutler E. 2006. Disorders of iron metabolism. Williams Hematology, 7th ed., 40: 511-553.
• Chertow G.M., Mason P.D., Vaage-Nilsen O., Ahl men J. 2004. On the relative safety of parenteral iron formulations. Nephrol. Dial. Transplant., 19: 1571-75.
• Chertow G.M., Mason P.D., Vaage-Nilsen O., Ahl men J. 2006. Update on adverse drug events associated with parenteral iron. Nephrol. Dial. Transplant., 21: 378-382.
• Crichton R.R., Wilmet S., Legssyer R., Ward R.J. 2002. Molecular and cellular mechanisms of iron homeostasis and toxicity in mammalian cells. J. Inorg. Biochem., 91: 9-18.
• Connor J.R., Boyer P.J., Menzies S.L., et al. 2003. Neuropathological examination suggests impaired brain iron acquisition in restless legs syndrome. Neurology, 61(3): 304-309.
• Connor J.R. 2008. Pathophysiology of restless legs syndrome: evidence for iron involvement. Curr. Neurol. Neurosci. Rep., 8(2): 162-166.
• Davis B.J., Rajput A., Rajput M.L., Aul E.A., Eichh orn G.R. 2000. A randomized, double-blind placebo-controlled trial of iron in restless legs syndrome. Eur. Neurol., 43(2): 70-75.
• Earley Ch.J., Heckler D., All en R.P. 2004. The treatment of restless legs syndrome with intravenous iron dextran. Sleep Med., 5(3): 231-235.
• Earley Ch. J. 2009. The importance of oral iron therapy in restless legs syndrome, Sleep Med., 10: 945-946.
• Feder J.N., Gnirke A., Thomas W. et al. 1996. A novel MHC class I-like gene is mutated in patients with hereditary haemochromatosis. Nat. Genet.,13: 399-408.
• Franchini M. 2006. Hereditary iron overload: update on pathophysiology, diagnosis, and treatment. Am. J. Hematol., 81: 202-209.
• Heeney M.M., Andrews N.C. 2004. Iron homeostasis and inherited iron overload disorders: an overview. Hematol. Oncol. Clin. North Am., 18: 1379-1403.
• Kemna E.H., Tjalsma H., Will ems H.L., Swinkels D.W. 2008. Hepcidin: from discovery to differential diagnosis. Haematologica, 93: 90-97.
• Kohg o Y., Ikuta K., Ohtake T., Torimoto Y., Kato J. 2008. Body iron metabolism and pathophysiology of iron overload. Int. J. Hematol., 88: 7-15.
• Liu D.Y., Liu Z.D., Hider R.C. 2002. Oral iron chelators: development and application. Best Pract. Res. Clin. Haematol., 15: 369-384.
• Milman N. 2006. Iron prophylaxis in pregnancy – general or individual and in which dose? Ann. Hematol., 85: 821-828.
• Milman N. 2008. Pre-partum anemia: prevention and treatment. Ann. Hematol., 87: 949-959.
• O’Keeffe S.T., Gavin K., Lavan J.N. 1994. Iron status and restless legs syndrome in the lderly. Age Ageing, 23(3): 200-203.
• Ondo W. G. 2005. Restless legs syndrome. Curr Neurol Neurosci Rep, 5: 266-274.
• Ondo W. G. 2010. Intravenous iron dextran for severe refractory restless legs syndrome, Sleep Med., 11: 494-496.
• Paesano R., Torcia F., Berlutti F., Pacifici E., Ebano V., Moscarini M., Valenti P. 2006. Oral administration of lactoferrin increases hemoglobin and total serum iron in pregnant women. Biochem. Cell Biol., 84: 377-380.
• Paesano R., Pietropaoli M., Gessani S., Valenti P. 2009. The influence of lactoferrin, orally administered, on systemic iron homeostasis in pregnant women suffering of iron deficiency and iron deficiency anaemia. Biochimie, 91: 44-51.
• Pasternak K. 2000. Bioelements in medical practice. Akad. Med. w Lublinie, s. 64-72. (in Polish)
• Pietrangelo A. 2004. Hereditary hemochromatosis – a new look at an old disease. N. Engl. J. Med., 350: 2383-2397.
• Rimon E., Kagansky N., Kagansky M., Mechnick L., Mashiah T., Namir M., Levy S. 2005. Are we giving too much iron? Low-dose iron therapy is effective in octogenarians. Am. J. Med., 118: 1142-1147.
• Wang J., O’Reilly B., Venkataraman R., et al. 2009. Efficacy of oral iron in patients with restless legs syndrome and a low-normal ferritin: a randomized double-blind, placebo-controlled study. Sleep Med., 9: 973-975.
• Vermylen Ch. 2008. What is new in iron overload? Eur. J. Pediatr., 167: 377-381.
• Wanless I.R., Sweeney G., Dhill on A.P. et al. 2002. Lack of progressive hepatic fibrosis during long-term therapy with deferiprone in subjects with transfusion-dependent betathalassemia. Blood, 100: 1566-1569.
• Weinberg E.D. 2010. First trimester curtailment of iron absorption: Innate suppression of a teratogen. Med Hypotheses, 74: 246-247.
• Yen A.W., Fancher T.L., Bowlus C.L. 2006. Revisiting hereditary hemochromatosis: current concepts and progress. Am. J. Med., 119: 391-399.

Identyfikatory

DOI

10.5601/jelem.2014.19.3.698