Alex H Gifford1, Diana M Alexandru2, Zhigang Li3, Dana B Dorman4, Lisa A Moulton5, Katherine E Price6, Thomas H Hampton7, Mitchell L Sogin8, Jonathan B Zuckerman9, H Worth Parker10, Bruce A Stanton11, George A O'Toole12. 1. Pulmonary and Critical Care Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, United States. Electronic address: Alex.H.Gifford@hitchcock.org. 2. Division of Pulmonary and Critical Care, Maine Medical Center, Portland, ME 04102, United States. Electronic address: ALEXAD1@mmc.org. 3. Biostatistics and Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, United States. Electronic address: Zhigang.Li@dartmouth.edu. 4. Pulmonary and Critical Care Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, United States. Electronic address: Dana.B.Dorman@hitchcock.org. 5. Pulmonary and Critical Care Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, United States. Electronic address: Lisa.A.Moulton@hitchcock.org. 6. Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, United States. Electronic address: Katherine.E.Price@dartmouth.edu. 7. Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, United States. Electronic address: Thomas.H.Hampton@dartmouth.edu. 8. Josephine Bay Paul Center for Comparative Molecular Biology and Evolution, Marine Biological Laboratory, Woods Hole, MA 02543, United States. Electronic address: sogin@mbl.edu. 9. Division of Pulmonary and Critical Care, Maine Medical Center, Portland, ME 04102, United States. Electronic address: jzuckerman@cmamaine.com. 10. Pulmonary and Critical Care Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, United States. Electronic address: H.Worth.Parker@hitchcock.org. 11. Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, United States. Electronic address: bas@dartmouth.edu. 12. Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, United States. Electronic address: georgeo@dartmouth.edu.
Abstract
BACKGROUND:Iron supplementation for hypoferremic anemia could potentiate bacterial growth in the cystic fibrosis (CF) lung, but clinical trials testing this hypothesis are lacking. METHODS:Twenty-two adults with CF and hypoferremic anemia participated in a randomized, double-blind, placebo-controlled, crossover trial of ferrous sulfate 325mg daily for 6weeks. Iron-related hematologic parameters, anthropometric data, sputum iron, Akron Pulmonary Exacerbation Score (PES), and the sputum microbiome were serially assessed. Fixed-effect models were used to describe how ferrous sulfate affected these variables. RESULTS:Ferrous sulfate increased serum iron by 22.3% and transferrin saturation (TSAT) by 26.8% from baseline (p<0.05) but did not affect hemoglobin, sputum iron, Akron PES, and the sputum microbiome. CONCLUSIONS:Low-dose ferrous sulfate improved hypoferremia without correcting anemia after 6weeks. We did not observe significant effects on sputum iron, Akron PES, and the sputum microbiome. Although we did not identify untoward health effects of iron supplementation, a larger blinded randomized controlled trial would be needed to fully demonstrate safety.
RCT Entities:
BACKGROUND:Iron supplementation for hypoferremic anemia could potentiate bacterial growth in the cystic fibrosis (CF) lung, but clinical trials testing this hypothesis are lacking. METHODS: Twenty-two adults with CF and hypoferremic anemia participated in a randomized, double-blind, placebo-controlled, crossover trial of ferrous sulfate 325mg daily for 6weeks. Iron-related hematologic parameters, anthropometric data, sputum iron, Akron Pulmonary Exacerbation Score (PES), and the sputum microbiome were serially assessed. Fixed-effect models were used to describe how ferrous sulfate affected these variables. RESULTS:Ferrous sulfate increased serum iron by 22.3% and transferrin saturation (TSAT) by 26.8% from baseline (p<0.05) but did not affect hemoglobin, sputum iron, Akron PES, and the sputum microbiome. CONCLUSIONS: Low-dose ferrous sulfate improved hypoferremia without correcting anemia after 6weeks. We did not observe significant effects on sputum iron, Akron PES, and the sputum microbiome. Although we did not identify untoward health effects of iron supplementation, a larger blinded randomized controlled trial would be needed to fully demonstrate safety.
Authors: Sophie Moreau-Marquis; Jennifer M Bomberger; Gregory G Anderson; Agnieszka Swiatecka-Urban; Siying Ye; George A O'Toole; Bruce A Stanton Journal: Am J Physiol Lung Cell Mol Physiol Date: 2008-03-21 Impact factor: 5.464
Authors: Julia E Heck; Angeline S Andrew; Tracy Onega; James R Rigas; Brian P Jackson; Margaret R Karagas; Eric J Duell Journal: Environ Health Perspect Date: 2009-07-02 Impact factor: 9.031
Authors: Katherine M Antosca; Diana A Chernikova; Courtney E Price; Kathryn L Ruoff; Kewei Li; Margaret F Guill; Natalie R Sontag; Hilary G Morrison; Shuyu Hao; Mitchell L Drumm; Todd A MacKenzie; Dana B Dorman; Lynn M Feenan; Molly A Williams; John Dessaint; Irene H Yuan; Brian J Aldrich; Lisa A Moulton; Lily Ting; Ana Martinez-Del Campo; Edward J Stewart; Margaret R Karagas; George A O'Toole; Juliette C Madan Journal: J Bacteriol Date: 2019-07-24 Impact factor: 3.490
Authors: Claire Healy; Natalia Munoz-Wolf; Janné Strydom; Lynne Faherty; Niamh C Williams; Sarah Kenny; Seamas C Donnelly; Suzanne M Cloonan Journal: Respir Res Date: 2021-04-29
Authors: Moon Jeong Lee; Jessica A Alvarez; Ellen M Smith; David W Killilea; James F Chmiel; Patricia M Joseph; Ruth E Grossmann; Amit Gaggar; Thomas R Ziegler; Vin Tangpricha Journal: Nutr Clin Pract Date: 2015-06-15 Impact factor: 3.080
Authors: Alex H Gifford; Dana B Dorman; Lisa A Moulton; Jennifer E Helm; Mary M Griffin; Todd A MacKenzie Journal: Clin Transl Sci Date: 2015-12-08 Impact factor: 4.689