Dual action of vitamin C in iron supplement therapeutics for iron deficiency anemia: prevention of liver damage induced by iron overload

Food Funct. 2018 Oct 17;9(10):5390-5401. doi: 10.1039/c7fo02057k.

Abstract

Vitamin C, an excellent reducing agent, aids in increasing absorbable ferrous iron in iron deficiency anemia. As an efficient antioxidant, it is still unknown whether vitamin C exerts protective effects against liver damage caused by iron excess and whether mitochondria are the target effectors of the above effects. In this study, 48 mice were randomly divided into a control group, iron-overload group, TAU-treated + iron-overload group and vitamin C-treated + iron-overload group with 12 mice per group. The mice were fed 4 months on pellet diets supplemented with iron in the form of ferrocene. The iron ratio in the diet was maintained at 0.2% (w/w) for 90 days and then 0.4% (w/w) for the remaining 30 days. Furthermore, 2 g kg-1 vitamin C and 20 mg kg-1 TAU were administered daily by oral gavage prior to iron-overload administration at 6 weeks and throughout the course of the experiments. We investigated the protective effects of vitamin C against liver damage by assessing the liver weight to body weight ratio (LW/BW), serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities, and histological changes. In addition, enzymatic and non-enzymatic antioxidants, reactive oxygen species (ROS) generation, mitochondrial swelling, and mitochondrial membrane potential (MMP) were evaluated to clarify the antioxidant effects of vitamin C. We found that vitamin C significantly attenuated impaired liver function in mice induced by iron overload via antioxidation, whereas no significant effect on iron uptake was observed. Vitamin C targeted the mitochondria, preventing mitochondrial swelling, MMP dissipation, and ROS burst, thus inhibiting hepatic apoptosis. Collectively, our results suggest that vitamin C acts as a "double agent" in iron supplementation therapy for iron deficiency anemia, boosting iron absorption for preventing iron deficiency and preventing liver damage due to excessive iron intake during treatment.

MeSH terms

  • Alanine Transaminase
  • Anemia, Iron-Deficiency / complications
  • Anemia, Iron-Deficiency / drug therapy*
  • Animals
  • Antioxidants / administration & dosage
  • Ascorbic Acid / administration & dosage*
  • Aspartate Aminotransferases
  • Dietary Supplements / adverse effects
  • Dietary Supplements / analysis
  • Ferrous Compounds / administration & dosage
  • Ferrous Compounds / adverse effects
  • Glutathione Peroxidase / metabolism
  • Humans
  • Iron / administration & dosage
  • Iron / adverse effects*
  • Iron Overload / complications*
  • Iron Overload / etiology
  • Liver / drug effects
  • Liver / enzymology
  • Liver / metabolism
  • Liver Diseases / etiology
  • Liver Diseases / metabolism
  • Liver Diseases / prevention & control*
  • Male
  • Malondialdehyde / metabolism
  • Membrane Potential, Mitochondrial / drug effects
  • Metallocenes / administration & dosage
  • Metallocenes / adverse effects
  • Mice
  • Oxidative Stress
  • Reactive Oxygen Species / metabolism

Substances

  • Antioxidants
  • Ferrous Compounds
  • Metallocenes
  • Reactive Oxygen Species
  • Malondialdehyde
  • Iron
  • Glutathione Peroxidase
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Ascorbic Acid
  • ferrocene