Efficacy and safety of free iron in total parenteral nutrition (TPN) admixtures : an experimental study in rats

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  • Harada Daisuke
    Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc.
  • Tanaka Makoto
    Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc.
  • Nakai Teru
    Pharmaceutical Technology Department, Technical Center, Otsuka Pharmaceutical Factory, Inc.
  • Kato Yui
    Pharmaceutical Technology Department, Technical Center, Otsuka Pharmaceutical Factory, Inc.
  • Sawamoto Osamu
    Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc.
  • Kuwahara Takashi
    Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc.

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  • ラットを用いた中心静脈栄養（TPN）輸液中の遊離鉄の有効性と安全性に関する検討

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It has been reported that colloidal iron (III) admixed in total parenteral nutrition (TPN) solutions converts to free iron (II) over time. In this study, we investigated the efficacy and safety of free iron administered by TPN for 21 days in rats and compared the findings with colloidal iron co-administered with TPN [M1]. The efficacy of iron supplementation for hematopoiesis in the free iron group was no less than that in the colloidal iron group, because the hematological values were well maintained during the 21 days in both groups. Although the transferrin saturation increased significantly in the free iron group, and the highest ratio was 35% in the free iron group. The excretions of iron in the urine were negligible in both groups. These results suggest that unsaturated iron-binding capacity is too much for the amount of free iron in TPN admixtures, and that the free iron infused was immediately caught by transferrin. The serum hepcidin-25 concentration was significantly higher in the free iron group than in the colloidal iron group, due to the significant increase of transferrin saturation. However, the elevation of hepcidin-25 concentration was considered to be a response within the physiological level, because the hematopoietic efficacy in the free iron group was confirmed. The results of tissue iron concentrations and histopathological evaluations revealed the typical tissue distributions of iron, reflecting in vivo kinetics of free iron or colloidal iron, but no abnormal changes were observed. There were no differences in oxidative stress markers. The results of this study suggest that free iron in TPN admixtures would not impair the efficacy or safety of iron supplementation due to the small amount and the slow infusion.

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