High-dose parenteral iron sucrose depresses neutrophil intracellular killing capacity

Deicher, Robert; Ziai, Farzad; Cohen, Gerald; Müllner, Marcus; Hörl, Walter H.

doi:10.1046/j.1523-1755.2003.00125.x

Cited by 82 publications

(57 citation statements)

References 38 publications

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“…A marked decrease in intracellular killing of bacteria was noted in hemodialysis patients with a serum ferritin Ͼ650 g/L (78). Peritoneal dialysis patients who received high-dosage intravenous iron had impaired ability of PMNL to eradicate Escherichia coli bacteria (79). Both iron sucrose and ferric gluconate inhibit migration of PMNL through endothelial cells in doses equivalent to concentrations measured in the plasma of dialysis patients who were treated with these intravenous iron products.…”

Section: Critical Evaluation Of the Risk Of Iron Administrationmentioning

confidence: 99%

Clinical Aspects of Iron Use in the Anemia of Kidney Disease

Hörl¹

2007

Journal of the American Society of Nephrology

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129

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Section: Critical Evaluation Of the Risk Of Iron Administrationmentioning

confidence: 99%

Clinical Aspects of Iron Use in the Anemia of Kidney Disease

Hörl¹

2007

Journal of the American Society of Nephrology

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129

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“…This labile iron pool has been associated with several deleterious actions, namely interfering with the inflammatory responses and promoting oxidant stress and endothelial dysfunction. In particular, nontransferrin-bound iron may promote bacterial growth [10], by altering leukocytes killing capacity [11], down-regulating proinflammatory immune effector pathways and stimulating the expression of the anti-inflammatory cytokine IL-4 [12]. In addition, even small traces of iron salts can increase oxidant stress by promoting lipid peroxidation and the superoxide-dependent formation of hydroxyl radicals from hydrogen peroxide [13,14,15] and cause acute endothelial dysfunction [16].…”

Section: Introductionmentioning

confidence: 99%

Slow Intravenous Iron Administration Does Not Aggravate Oxidative Stress and Inflammatory Biomarkers during Hemodialysis: A Comparative Study between Iron Sucrose and Iron Dextran

et al. 2007

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Background/Aims: Fast intravenous (i.v.) iron administration during hemodialysis (HD) is associated with the augmentation of oxidative stress and the increase in inflammatory biomarkers, which are also induced by the hemodialysis procedure itself. The aim of this study was to investigate if slow i.v. iron administration would aggravate the status of oxidative stress and inflammatory biomarkers during a hemodialysis session. Methods: Twenty dialysis patients 30–92 years of age that were iron replete and had values for hemoglobin, transferrin saturation and serum ferritin among recommended goals were evaluated in three separate hemodialysis sessions. In the first session patients did not receive any iron treatment, whereas during the second and the third session patients received slow (60 min) i.v. infusions of 100 mg of iron sucrose and 100 mg of iron dextran, respectively. Blood samples were drawn before the hemodialysis session, 15 min after the end of iron administration and at the end of the hemodialysis session in all occasions, for the measurement of markers of oxidant stress (oxidized LDL and ischemia-modified albumin) and inflammation (high-sensitivity C-reactive protein, interleukin-6 and tumor necrosis factor-α). Results: Oxidized LDL was not significantly altered during hemodialysis and this pattern was similar between the three occasions studied. In contrast, ischemia-modified albumin was significantly increased and this effect was also not different between the net hemodialysis and the occasions of iron administration. High-sensitivity CRP, IL-6 and TNF-α were all significantly elevated during hemodialysis and again both types of iron administration did not produce significant changes in this pattern. Conclusion: We did not find an increase in the markers of oxidation/inflammation studied, after slow i.v. iron administration during hemodialysis session.

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“…One clinical study evaluating the effect of an iron sucrose formulation demonstrated that polymorphonuclear leukocytes isolated from patients treated with the NP formulation showed less bacterial killing of E. coli ex vivo than patients administered a placebo, although the results were not significant and only occurred immediately after administration of the parenteral iron compound. 41 The impact of systemic administration of NPs as well as repeat dosing of NPs is not yet known.…”

mentioning

confidence: 99%

Effect of silica and gold nanoparticles on macrophage proliferation, activation markers, cytokine production, and phagocytosis in vitro

Bancos¹,

Stevens²,

Tyner³

2014

IJN

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The accumulation of durable nanoparticles (NPs) in macrophages following systemic administration is well described. The ultimate biological impact of this accumulation on macrophage function, however, is not fully understood. In this study, nontoxic doses of two durable NPs, SiO 2 and Au, at particle sizes of ~10 nm and 300 nm were used to evaluate the effect of bioaccumulation on macrophage function in vitro using RAW 264.7 mouse macrophage-like cells as a model system. Cell proliferation, cell cycle, cytokine production, surface marker activation, and phagocytosis responses were evaluated through a panel of assays using flow cytometry and confocal microscopy. The most dramatic change in RAW 264.7 cell function was a reduction in phagocytosis as monitored by the uptake of Escherichia coli . Cells exposed to both 10 nm Au NPs and 10 nm SiO 2 NPs showed ~50% decrease in phagocytosis, while the larger NPs caused a less dramatic reduction. In addition to modifying phagocytosis profiles, 10 nm SiO 2 NPs caused changes in proliferation, cell cycle, and cell morphology. Au NPs had no effect on cell cycle, cytokine production, or surface markers and caused interference in phagocytosis in the form of quenching when the assay was performed via flow cytometry. Confocal microscopy analysis was used to minimize this interference and demonstrated that both sizes of Au NPs decreased the phagocytosis of E. coli . Overall, our results demonstrate that Au and SiO 2 NP uptake by macrophages can influence macrophage phagocytosis in vitro without altering surface markers and cytokine production in vitro. While the biological impact of these findings remains unclear, our results indicate that bioaccumulation of durable NPs within the macrophages may lead to a suppression of bacterial uptake and possibly impair bactericidal activity.

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High-dose parenteral iron sucrose depresses neutrophil intracellular killing capacity

Abstract: Killing capacity of PMN isolated from ESRD patients decreases in response to high-dose parenteral iron sucrose, possibly in part explaining reported higher hospitalization rates and lower survival rates of dialysis patients receiving frequent and high-dose parenteral iron.

Cited by 82 publications

References 38 publications

Clinical Aspects of Iron Use in the Anemia of Kidney Disease

Clinical Aspects of Iron Use in the Anemia of Kidney Disease

Slow Intravenous Iron Administration Does Not Aggravate Oxidative Stress and Inflammatory Biomarkers during Hemodialysis: A Comparative Study between Iron Sucrose and Iron Dextran

Effect of silica and gold nanoparticles on macrophage proliferation, activation markers, cytokine production, and phagocytosis in vitro

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