Showing 3 ideas for tag "iron"

Goal 1: Promote Human Health

Iron Loss after Blood Donation and Its Effect on Donors’ Health

What is the effect of donation-induced iron deficiency on blood donor health?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

Blood donation removes iron, and frequent blood donors commonly have low or absent iron stores. Donation frequency remains the strongest predictor of iron depletion among all donors, after controlling for body mass, race/ethnicity, and polymorphisms affecting iron metabolism. Less well documented is the effect of iron depletion on blood donor health and well-being. Iron deficiency may have a broad spectrum of physical and neurologic consequences, including impaired work capacity, altered cognitive function, pica and restless legs syndrome. The prevalence, duration, and severity of these conditions in blood donor populations are poorly elucidated. In contrast, modest iron deficits may be protective against cancer and cardiovascular disease. Some investigators have demonstrated the feasibility to connect donor information with clinical databases to study whether donation behavior and iron status have long-term consequences for donor health.

Feasibility and challenges of addressing this CQ or CC

Studying the short-term clinical impact of donation-induced iron deficiency presents logistical and methodological challenges. Many outcomes of interest are not observable by blood center staff under routine procedures; further, such studies are subject to selection bias due to donor failure to return to donate following low hemoglobin deferral or adverse outcomes they associate with donation. However, given the size and demographic diversity of donor populations, even uncommon outcomes can be successfully studied under a multi-center approach. A prospective approach that doesn’t condition enrollment or completion of the study on return to donate, may avoid the methodological pitfalls. A wide array of clinical or neurological outcomes can feasibly be studied with sufficient blood centers and/or donor follow-up.

Name of idea submitter and other team members who worked on this idea Dana Devine PhD and Anne Eder MD PhD for the 2015 NHLBI State of the Science in Transfusion Medicine

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Goal 3: Advance Translational Research

Role of anemia and iron deficiency anemia on hemoglobin A1C%

Many forms of anemia are associated with lowering HbA1C% but iron deficiency anemia modestly raises HbA1C%. The exact mechanism of anemia and iron deficiency anemia's effect on HbA1c levels is unclear. This impacts our treatment of diabetes mellitus and diabetes mellitus co-morbidity with HIV, Hepatitis C and other diseases in the presence of anemia.

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Details on the impact of addressing this CQ or CC

Hemoglobin A1c (HbA1C%) is a widely used marker for the diagnosis and treatment of diabetes mellitus (DM). Understanding how anemia and iron deficiency anemia affects HbA1C% informs the practitioner on proper dosing of oral and insulin based medication regimens, on the impact of diet and exercise in HbA1C% and erythrocyte turnover, and the incidence and prevalence of DM in sub-populations.

Feasibility and challenges of addressing this CQ or CC

With the advent of continous glucose monitoring, studies can be set up for measuring impact of disease state, medication and lifestyle on erythrocyte and seum glucose in addition to basic science on hemoglobin/RBC changes under varying glucose concentrations

Name of idea submitter and other team members who worked on this idea JocelynR

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Goal 1: Promote Human Health

The Biochemistry and Physiology of Acute Blood and Iron Loss after Blood Donation

What are the biochemical and physiological responses to the acute blood and iron loss that occur during blood donation?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

A whole blood donation rapidly removes approximately 10% of total blood volume within about 15 minutes, providing a unique opportunity to examine how biochemical pathways regulating iron metabolism and hemoglobin biosynthesis respond to acute hemorrhage in otherwise healthy individuals. Genetic studies could examine the impact of polymorphisms of iron regulatory and hemoglobin biosynthesis proteins on the physiological responses to blood donation and recovery from blood donation or to identify previously unrecognized polymorphisms and proteins that affect dietary iron absorption and hemoglobin synthesis. Blood donor diversity might enable research into the genetic determinants of the racial variability in hemoglobin set point or the changes in biochemical responses with aging. The results of basic studies in healthy individuals may also help to understand disease mechanisms and treatments for anemia, inflammation, iron overload, bone marrow expansion/bone health, infectious diseases, neurological disorders and cancer.

Feasibility and challenges of addressing this CQ or CC

Blood donors are often willing to participate in research studies, especially when study design allows completion in one donor visit. More complex studies requiring donor follow-up or an intervention can also be rapidly enrolled and completed based on past experience. Clinical assays to measure iron regulatory proteins are currently available and tools for complex genetic analyses are rapidly advancing. Thus, the likelihood of completing study enrollment and answering specific questions about responses of iron metabolism proteins to blood donation in a time period of 3-10 years is high.

Name of idea submitter and other team members who worked on this idea Dana Devine PhD and Anne Eder MD PhD for the 2015 NHLBI State of the Science in Transfusion Medicine

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