Figure 2. Physiological and biochemical events proposed to explain the anemia recovery during a treatment with both a protein and heme hydrolyzate and ionic Fe. The presence of peptides and amino acids (aa) released from the intestinal hydrolysis of bovine blood proteins decrease intestinal ionic Fe adverse effects and promote intestinal absorption mediated by DMT1. Oxidative effect generated at intestinal lumen by the presence of ionic Fe as Fe⁺² decreased, and is less stimulated antioxidant response regulated at the level of DNA regions called the nucleus ARE, which is mediated by activating transcription factors as Nrf2 and NF-kß. This situation conduces to decreased activation of antioxidant enzymes as SOD, GPx and HO-1. The low activities of the antioxidant enzymes, coupled with the decreasing availability of O₂ as a consequence of anemia, stimulated that heme absorbed from the intestinal lumen by the transporter HCP1 not be degraded at enterocyte level by HO-1, and it is exported to plasma as an intact metalloporphyrin. This process may be mediated by membrane transporters as FLCVR or the ATP-Binding Cassette, subfamily G, a member 2 protein (ABCG2). In plasma, the heme is carried by hemopexin to the bone marrow where is transported to erythroid cells by heme response gen 1 transporter (HRG-1). Inside erythroid cell, heme molecule can be incorporated into hemoglobin synthesis process and this would be a more efficient way to recover from anemia situation that when erythroid cell only depends of heme synthesis

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Advantages of the Supplementation with both a Protein and Heme Hydrolyzate and Ionic Iron during Iron Deficiency Anemia

Yenela García, Olimpia Carrillo, René Cárdenas, Javier Díaz-Castro

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