Transferrin therapy study

Iron removal Increased iron and ferritin levels are found in approx. 30% of patients with chronic hepatitis B or C. Several studies have shown that the success rate of interferon therapy is reduced in the presence of elevated liver iron values. This is attributed to the fact that iron overload inhibits not only lymphocyte proliferation, but also the function of killer cells and B cells as well as the production of antibodies. Iron plays a role in the formation of free radicals and the occurrence of dangerous lipid peroxidations, (s. pp 68, 401) Furthermore, iron, like oxygen radicals, promotes fibrogenesis. Iron removal leads to an improvement in laboratory parameters and better response to interferon-a therapy. (217, 243) On the other hand, the iron level is reduced as a result of successful IFN therapy. In the case of a higher serum iron status before the initiation of interferon therapy, venesections at one week intervals should be considered, if necessary until normal laboratory values (iron, ferritin, transferrin saturation) have been restored. During interferon therapy, a low-iron diet is advisable, as is the consumption of 2 x 1 cup of black tea (in the morning and at noon) to reduce iron absorption through chelate formation ( cheap, free of side effects and useful )- (s. p. 625) Silymarin also leads to iron mobilization due to chelate formation. 

Amino acid dialysate (AAD) is the IDPN counterpart for the CAPD patient. This technique entails using a 1.1% amino acid solution in place of one or two of the dextrose-containing PD exchanges per day. Improvements in serum transferrin and total protein concentrations have been observed in malnourished CAPD patients however, no beneficial effect has been noted on patient mortality. " Adverse effects of this therapy have included exacerbations of uremic symptoms (due to increases in blood urea nitrogen) and metabolic acidosis. Not all studies have demonstrated benefits from this intervention. In summary, AAD may be useful in the treatment of malnourished CAPD patients, but better designed studies are needed. 

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