Fabrication of a donkey spleen ferritin-pectin complex to reduce iron release and enhance the iron supplementation efficacy.

Iron deficiency is a global issue, influencing more than one-third of the population in the world. Ferritin as a natural iron-containing protein is considered a marvelous iron supplement due to its biocompatibility, biodegradability and bioavailability. However, foodstuffs contain plenty of reductants which could induce iron release from the cavity of ferritin and cause oxidative damage. In this study, we aimed to prevent the iron release from donkey spleen ferritin (DSF) by pectin encapsulation driven by the electrostatic interaction and evaluated the iron supplementation of the DSF-pectin complex (DPC). After DSF was purified, we fabricated the DPC and the iron release was decreased by 53.68% after 60 min when DSF : pectin was 1 : 10 (w/w). TEM analysis showed that ferritin in the DPC is clustered in a linear pattern, and the cell viability assay indicated that the DPC has no toxicity towards Caco-2 cells. In the mouse experiment, the DPC increased the content of serum iron and serum ferritin with no significant difference from the control check. Furthermore, the DPC increased the iron content in the liver, suppressed the expression of hepcidin and increased the expression of ferroportin. These results suggested that the DPC could prevent the interactions between food components and ferritin and is a promising iron supplement to ameliorate iron deficiency.

New Internet-Based Warfarin Anticoagulation Management Approach After Mechanical Heart Valve Replacement: Prospective, Multicenter, Randomized Controlled Trial.

BACKGROUND: Mechanical heart valve replacement (MHVR) is an effective method for the treatment of severe heart valve disease; however, it subjects patient to lifelong warfarin therapy after MHVR with the attendant risk of bleeding and thrombosis. Whether internet-based warfarin management reduces complications and improves patient quality of life remains unknown. OBJECTIVE: This study aimed to compare the effects of internet-based warfarin management and the conventional approach in patients who received MHVR in order to provide evidence regarding alternative strategies for long-term anticoagulation. METHODS: This was a prospective, multicenter, randomized, open-label, controlled clinical trial with a 1-year follow-up. Patients who needed long-term warfarin anticoagulation after MHVR were enrolled and then randomly divided into conventional and internet-based management groups. The percentage of time in the therapeutic range (TTR) was used as the primary outcome, while bleeding, thrombosis, and other events were the secondary outcomes. RESULTS: A total of 721 patients were enrolled. The baseline characteristics did not reach statistical differences between the 2 groups, suggesting the random assignment was successful. As a result, the internet-based group showed a significantly higher TTR (mean 0.53, SD 0.24 vs mean 0.46, SD 0.21; P<.001) and fraction of time in the therapeutic range (mean 0.48, SD 0.22 vs mean 0.42, SD 0.19; P<.001) than did those in the conventional group. Furthermore, as expected, the anticoagulation complications, including the bleeding and embolic events had a lower frequency in the internet-based group than in the conventional group (6.94% vs 12.74%; P=.01). Logistic regression showed that internet-based management increased the TTR by 7% (odds ratio [OR] 1.07, 95% CI 1.05-1.09; P<.001) and reduced the bleeding and embolic risk by 6% (OR 0.94, 95% CI 0.92-0.96; P=.01). Moreover, low TTR was found to be a risk factor for bleeding and embolic events (OR 0.87, 95% CI 0.83-0.91; P=.005). CONCLUSIONS: The internet-based warfarin management is superior to the conventional method, as it can reduce the anticoagulation complications in patients who receive long-term warfarin anticoagulation after MHVR. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1800016204; http://www.chictr.org.cn/showproj.aspx?proj=27518. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2019-032949.