Department of Obstetrician and Gynecology, Sapienza University of Rome, Italy.
Int J Immunopathol Pharmacol. 2010 Apr-Jun;23(2):577-87. doi: 10.1177/039463201002300220.
Iron homeostasis in pregnancy compensates for increased iron requirements and in women of child-bearing age for iron loss in menses. Oral administration of ferrous sulfate, prescribed to cure iron deficiency (ID) and ID anemia (IDA), often fails to increase hematological parameters and causes adverse effects. Recently, we demonstrated safety and efficacy of bovine lactoferrin (bLf) in pregnant women suffering from ID/IDA. Two clinical trials were conducted on pregnant and non-pregnant women of child-bearing age suffering from ID/IDA. In both trials, women received oral administration of bLf 100 mg/twice/day (Arm A), or ferrous sulfate 520 mg/day (Arm B). Hematological parameters, serum IL-6 and prohepcidin were assayed before and after therapy. Unlike ferrous sulfate, bLf increased hematological parameters (P less than 0.0001). In pregnant women, bLf decreased serum IL-6 (P less than 0.0001), and increased prohepcidin (P=0.0007). In non-pregnant women bLf did not change the low IL-6 levels while it increased prohepcidin (P less than 0.0001). Ferrous sulfate increased IL-6 (P less than 0.0001) and decreased prohepcidin (P=0.093). bLf established iron homeostasis by modulating serum IL-6 and prohepcidin synthesis, whereas ferrous sulfate increased IL-6 and failed to increase hematological parameters and prohepcidin. bLf is a more effective and safer alternative than ferrous sulfate for treating ID and IDA.
铁在妊娠期间的体内平衡可补偿铁需求的增加，在育龄妇女中可补偿月经导致的铁丢失。硫酸亚铁用于治疗缺铁（ID）和缺铁性贫血（IDA），但常因无法增加血液学参数而导致不良反应。最近，我们证明了牛乳铁蛋白（bLf）在患有 ID/IDA 的孕妇中的安全性和疗效。进行了两项临床试验，一项针对患有 ID/IDA 的孕妇，另一项针对育龄期非孕妇。在两项试验中，女性均接受 bLf（100mg/次，每日两次，A 组）或硫酸亚铁（520mg/日，B 组）口服治疗。治疗前后测定血液学参数、血清 IL-6 和前铁调素。与硫酸亚铁不同，bLf 可增加血液学参数（P 小于 0.0001）。在孕妇中，bLf 降低血清 IL-6（P 小于 0.0001），并增加前铁调素（P=0.0007）。在非孕妇中，bLf 并未改变低水平的 IL-6，但增加了前铁调素（P 小于 0.0001）。硫酸亚铁增加了 IL-6（P 小于 0.0001）并降低了前铁调素（P=0.093）。bLf 通过调节血清 IL-6 和前铁调素合成来建立铁体内平衡，而硫酸亚铁增加了 IL-6，且无法增加血液学参数和前铁调素。bLf 是治疗 ID 和 IDA 比硫酸亚铁更有效和更安全的替代药物。
