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The Effect of Ovotransferrin and Lactoferrin on Iron Absorption From Ferrous Sulfate in Adult Women (OTf)

Primary Purpose

Iron-deficiency

Status
Completed
Phase
Not Applicable
Locations
Switzerland
Study Type
Interventional
Intervention
FeSO4 + OTf
FeSO4 + Lf
FeSO4
Sponsored by
Swiss Federal Institute of Technology
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Iron-deficiency

Eligibility Criteria

18 Years - 45 Years (Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria:

  • female aged between 18-45 years old;
  • SF <25 µg / L;
  • BMI 18.5-24.9 kg / m2;
  • weight <70 kg;
  • signed informed consent;
  • Able to communicate and comprehend English language.

Exclusion Criteria:

  • Anemic (Hb <12 g / dL);
  • inflammation (CRP> 5 mg / L);
  • chronic digestive, renal and / or metabolic disease;
  • chronic medications (except for oral contraceptives);
  • use of vitamin, mineral and pre- and / or probiotic supplements in the previous 2 weeks and during the course of the study;
  • blood transfusion, blood donation or significant blood loss over the past 4 months;
  • difficulties with blood sampling;
  • antibiotic treatment in the previous 4 weeks before the start of the study and during the course of the study;
  • known hypersensitivity to egg;
  • pregnancy (tested in serum at screening) or intention to become pregnant during the course of the study;
  • lactation up to 6 weeks before study initiation;

Sites / Locations

  • ETH Zurich, Laboratory of Human Nutrition

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Other

Other

Other

Arm Label

OTf + FeSO4

Lf+ FeSO4

FeSO4

Arm Description

OTf + FeSO4 - This is the experimental arm where Ferrous sulfate will be given to the participants along with apo-Ovotransferrin, a potential iron absorption enhancer. They will be given as solutions that will be spread on bread with butter and honey, a breakfast meal.

Lf + FeSO4 - This is the experimental arm where Ferrous sulfate will be given to the participants along with lactoferrin, a potential iron absorption enhancer. They will be given as solutions that will be spread on bread with butter and honey, a breakfast meal.

FeSO4 - This is the control arm where Ferrous sulfate will be given in the form of a solution that will be spread on bread with butter and honey, as a breakfast meal

Outcomes

Primary Outcome Measures

Fractional iron absorption
The primary outcome is iron bioavailability (as measured by erythrocyte incorporation of the stable isotope labels) from the 2 different conditions in the standardized test meals.

Secondary Outcome Measures

Hemoglobin (Hb)
Iron status marker
Serum ferritin (SF)
Iron status marker
Serum transferrin receptor (sTfR),
Iron status marker
C-reactive protein (CRP)
Inflammation status

Full Information

First Posted
October 29, 2021
Last Updated
June 9, 2022
Sponsor
Swiss Federal Institute of Technology
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1. Study Identification

Unique Protocol Identification Number
NCT05233709
Brief Title
The Effect of Ovotransferrin and Lactoferrin on Iron Absorption From Ferrous Sulfate in Adult Women
Acronym
OTf
Official Title
The Effect of Ovotransferrin and Lactoferrin on Iron Absorption From Ferrous Sulfate in Adult Women With Non-anemic Iron Deficiency: Stable Isotope Study
Study Type
Interventional

2. Study Status

Record Verification Date
June 2022
Overall Recruitment Status
Completed
Study Start Date
April 25, 2022 (Actual)
Primary Completion Date
May 20, 2022 (Actual)
Study Completion Date
May 20, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Swiss Federal Institute of Technology

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
OTf is a monomeric glycoprotein of 686 amino acid residues and, as a member of the transferrin family, folds into two homologous globular lobes, each containing a single reversible Fe3 + binding site located within the interdomain cleft of each lobe. A comparison of apo (metal-free) and holostructures shows that iron binding or release in OTf occurs via a mechanism that involves opening or closing domains. human lactoferrin, transferrin, and OTf share the same reversible iron binding mechanism. Lactoferrin (Lf) is a 77 kDa glycosylated protein highly concentrated in human and bovine milk and can exist in an apo (metal free) state or can bind two ferric ions with very high affinity (k = 1022 M-1) forming holo-Lf . It has been recently reported that the addition of apo-Lf to a test meal containing FeSO4 significantly increased (+56%) iron absorption in young infants [19]. Despite these positive results in infants, to our knowledge, the ability of Lf to improve iron absorption from FeSO4 has not yet been assessed in adult women. OTf and Lf will be tested as iron absorption enhancers by comparing the fractional iron absorption with that of FeSO4, the most widely used iron supplement. This study will provide information on how to improve iron absorption.In a randomized single-blind crossover study, the iron bioavailability is determined by means of stable iron isotope technology via the incorporation of stable isotopes from intrinsically labeled compounds into the erythrocytes 14 days after the study product.
Detailed Description
Iron deficiency remains a major public health problem in both developed and developing countries. At present, iron deficiency is mostly combated with iron supplements in the form of iron salts, especially iron sulfate. Iron salts are absorbed via the nonhemic iron route via the DMT-1 receptor, the rate of absorption being 20% of the total iron content. The dietary supplement industry tries to counteract this problem and to supply the required amount of iron by increasing the iron concentration in the dietary supplements in order to compensate for the low absorption rate. However, the high dosage of iron leads to side effects. It would be more effective to maximize iron absorption rather than a high dose of iron. Chicken protein ovotransferrin (OTf) is recognized as an iron-binding protein and a member of the transferrin family. OTf has amino acid sequences that are identical to chicken serum transferrin and shows approximately 50% homology with mammalian transferrin and lactoferrin. Despite its iron binding properties and safety for human consumption, no studies have evaluated OTf as an enhancer of iron absorption in humans. OTf is a monomeric glycoprotein of 686 amino acid residues and, as a member of the transferrin family, folds into two homologous globular lobes, each containing a single reversible Fe3 + binding site located within the interdomain cleft of each lobe. A comparison of apo (metal-free) and holostructures shows that iron binding or release in OTf occurs via a mechanism that involves opening or closing domains. human lactoferrin, transferrin, and OTf share the same reversible iron binding mechanism. Lactoferrin (Lf) is a 77 kDa glycosylated protein highly concentrated in human and bovine milk and can exist in an apo (metal free) state or can bind two ferric ions with very high affinity (k = 1022 M-1) forming holo-Lf . There are various studies that show the iron bioavailability of intrinsically labeled holo-Lf and apo- Lf and FeSO4. Lf appears to be a good source of bioavailable iron in both infants and in adults. Whether this is due to iron absorption through the Lf receptor and/or due to iron released from Lf joining the common non-heme iron pool and being subsequently absorbed, remains uncertain. The high affinity of OTf for iron (∼1030 M-1) at pH 7.5 implies that in presence of apo-OTf, iron will be sequestered. Lf also possesses the ability to bind iron (binding constants of ∼1022-1024 M-1) and retain it at lower pH. This difference in iron binding capacity, however, is not sufficient to establish conclusive statements regarding the activity of OTf in iron absorption. It has been recently reported that the addition of apo-Lf to a test meal containing FeSO4 significantly increased (+56%) iron absorption in young infants. Despite these positive results in infants, to our knowledge, the ability of Lf to improve iron absorption from FeSO4 has not yet been assessed in adult women. Furthermore, despite its iron-binding properties and safety for human consumption, to the best of our knowledge, no studies have assessed OTf as an enhancer of iron absorption in humans. Therefore the use of OTf and Lf as iron absorption enhancers by comparing fractional iron absorption with that of FeSO4, the most commonly used iron supplement is investigated. This study will provide information regarding iron absorption enhancement, as well the behavior of OTf and Lf in adult women. OTf and Lf will be tested as iron absorption enhancers by comparing the fractional iron absorption with that of FeSO4, the most widely used iron supplement. This study will provide information on how to improve iron absorption.In a randomized single-blind crossover study, the iron bioavailability is determined by means of stable iron isotope technology via the incorporation of stable isotopes from intrinsically labeled compounds into the erythrocytes 14 days after the study product. Participants are given OTf, Lf and iron sulfate solutions. To quantify this, stable iron isotopes are used as marker substances. Stable isotopes exist in nature and in our body and there are no risks associated with their ingestion. No changes in the iron status of the subjects are expected during the study.35 women of childbearing age are being recruited for the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Iron-deficiency

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
Participant
Allocation
Randomized
Enrollment
35 (Actual)

8. Arms, Groups, and Interventions

Arm Title
OTf + FeSO4
Arm Type
Other
Arm Description
OTf + FeSO4 - This is the experimental arm where Ferrous sulfate will be given to the participants along with apo-Ovotransferrin, a potential iron absorption enhancer. They will be given as solutions that will be spread on bread with butter and honey, a breakfast meal.
Arm Title
Lf+ FeSO4
Arm Type
Other
Arm Description
Lf + FeSO4 - This is the experimental arm where Ferrous sulfate will be given to the participants along with lactoferrin, a potential iron absorption enhancer. They will be given as solutions that will be spread on bread with butter and honey, a breakfast meal.
Arm Title
FeSO4
Arm Type
Other
Arm Description
FeSO4 - This is the control arm where Ferrous sulfate will be given in the form of a solution that will be spread on bread with butter and honey, as a breakfast meal
Intervention Type
Dietary Supplement
Intervention Name(s)
FeSO4 + OTf
Intervention Description
OTf (apo ovotransferrin) + FeSO4
Intervention Type
Dietary Supplement
Intervention Name(s)
FeSO4 + Lf
Intervention Description
Lf (lactoferrin) + FeSO4
Intervention Type
Dietary Supplement
Intervention Name(s)
FeSO4
Intervention Description
Ferrous sulfate
Primary Outcome Measure Information:
Title
Fractional iron absorption
Description
The primary outcome is iron bioavailability (as measured by erythrocyte incorporation of the stable isotope labels) from the 2 different conditions in the standardized test meals.
Time Frame
Day 19th of the study
Secondary Outcome Measure Information:
Title
Hemoglobin (Hb)
Description
Iron status marker
Time Frame
Screening (-14,) day 1 and day 19th
Title
Serum ferritin (SF)
Description
Iron status marker
Time Frame
Screening (-14,) day 1 and day 19th
Title
Serum transferrin receptor (sTfR),
Description
Iron status marker
Time Frame
Screening (-14,) day 1 and day 19th
Title
C-reactive protein (CRP)
Description
Inflammation status
Time Frame
Screening (-14,) day 1 and day 19th

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: female aged between 18-45 years old; SF <25 µg / L; BMI 18.5-24.9 kg / m2; weight <70 kg; signed informed consent; Able to communicate and comprehend English language. Exclusion Criteria: Anemic (Hb <12 g / dL); inflammation (CRP> 5 mg / L); chronic digestive, renal and / or metabolic disease; chronic medications (except for oral contraceptives); use of vitamin, mineral and pre- and / or probiotic supplements in the previous 2 weeks and during the course of the study; blood transfusion, blood donation or significant blood loss over the past 4 months; difficulties with blood sampling; antibiotic treatment in the previous 4 weeks before the start of the study and during the course of the study; known hypersensitivity to egg; pregnancy (tested in serum at screening) or intention to become pregnant during the course of the study; lactation up to 6 weeks before study initiation;
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jessica Rigutto-Farebrother, PhD
Organizational Affiliation
Laboratory of Human Nutrition ETH Zürich
Official's Role
Principal Investigator
Facility Information:
Facility Name
ETH Zurich, Laboratory of Human Nutrition
City
Zurich
ZIP/Postal Code
8092
Country
Switzerland

12. IPD Sharing Statement

Plan to Share IPD
No

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The Effect of Ovotransferrin and Lactoferrin on Iron Absorption From Ferrous Sulfate in Adult Women

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