Iron Replacement and Redox Balance in Non-Anemic and Mildly Anemic Iron Deficiency COPD Patients: Insights from a Clinical Trial

• Published in: Biomedicines Vol. 9; no. 9; p. 1191
• Main Authors: Pérez-Peiró, Maria, Martín-Ontiyuelo, Clara, Rodó-Pi, Anna, Piccari, Lucilla, Admetlló, Mireia, Durán, Xavier, Rodríguez-Chiaradía, Diego A, Barreiro, Esther
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 10-09-2021; MDPI
• Subjects: Anemia; Antioxidants; Biomarkers; Body mass index; Carbonyl compounds; Catalase; Chronic obstructive pulmonary disease; Clinical trials; Disease; Glutathione; Hemoglobin; Hepcidin; Iron; Iron deficiency; iron metabolism; iron replacement as a therapeutic opportunity; Metabolism; Nitrotyrosine; non-anemic iron deficient (NAID) COPD patients; Nutrient deficiency; Oxidative stress; pathophysiological mechanisms; Patients; Placebos; Protein adducts; Proteins; redox balance; Respiratory diseases; Serum levels; Superoxide dismutase; Vitamin E; Womens health; iron metabolism; pathophysiological mechanisms; iron replacement as a therapeutic opportunity; redox balance; non-anemic iron deficient (NAID) COPD patients
• ISSN: 2227-9059; 2227-9059
• DOI: 10.3390/biomedicines9091191

In COPD patients, non-anemic iron deficiency (NAID) is a common systemic manifestation. We hypothesized that in COPD patients with NAID, iron therapy may improve systemic oxidative stress. The FACE (Ferinject assessment in patients with COPD and iron deficiency to improve exercise tolerance) study was a single-blind, unicentric, parallel-group, placebo-controlled clinical trial (trial registry: 2016-001238-89). Sixty-six patients were enrolled (randomization 2:1): iron arm,
= 44 and placebo arm,
= 22, with similar clinical characteristics. Serum levels of 3-nitrotyrosine, MDA-protein adducts, and reactive carbonyls, catalase, superoxide dismutase (SOD), glutathione, Trolox equivalent antioxidant capacity (TEAC), and iron metabolism biomarkers were quantified in both groups. In the iron-treated patients compared to placebo, MDA-protein adducts and 3-nitrotyrosine serum levels significantly declined, while those of GSH increased and iron metabolism parameters significantly improved. Hepcidin was associated with iron status parameters. This randomized clinical trial evidenced that iron replacement elicited a decline in serum oxidative stress markers along with an improvement in GSH levels in patients with stable severe COPD. Hepcidin may be a surrogate biomarker of iron status and metabolism in patients with chronic respiratory diseases. These findings have potential clinical implications in the management of patients with severe COPD.