Anemia
in Experimental
Rhesus
Protein
Monkey
with
to Iron
By
NEMIA
is an
protein
the
important
such
workers
V.
AND
of
Kwashiorkor,15
as iron6
assessing
the
role
of protein
malnutrition
per
se
the
and
syndrome
complicated
was
by
asin-
folic
that
is microcytic
The
reports
the
able.
Normocytic
but hypochromic5
iron
in serum
these
known.
and
a fall
and
folic
acid
have
and
in
the
been
primate
model,
we
se in the pathogenesis
sults
of this study
Africa,
responds
with
some
Kwashiorkor
to
the
synthesis
and
Hooper”
slowly
specific
workers
have
a high
protein
of hemoglobin
was
and
Jenks.1#{176}These
of hemoglobin
type
in laboratory
if the diet
consistently
in
serum
of
other
in
tube-feeding
nutrients
attempted
of
with
to
in
reported
are also
iron
animals
is supplemented
develop
anemia
and
been
iron
rhesus
binding
in
and
monkeys
the
anemia.
In this
special
reference
vari-
capacity
The
malnutrition
a syndrome
deficient
Using
role
have
Changes
observed.’9’20
protein
them
a diet
calories.21-23
elucidate
are
malnutrition.17’18
also
anemia
Kwashiorkor
most
commonly,37”2’13
reported.7’14
Disturbances
protein
B12 have
induce
by
anemia
is
experimental
vitamin
to
of
anemia
types
pathogenesis
able
to human
Kwashiorkor
but adequate
in all
human
often
in
hypochromic.11
morphologic
in human’5’16
changes
We
regeneration
studies
recently
of
protein
in
by Whipple
normochromic
and megaloblastic
absorption,
found
However,
anemia
his
This
anemia
is supplemented
phlebotomy
is enhanced
on a protein-deficient
diet
and
on
acid.7
the
of
of
basis
and
through
Rats kept
a syndrome
the
in Kwashiorkor,
since
nutritional
deficiencies
demonstrated
anemic
protein.
which
in
Dio
on
reported
a good
response
of
diet without
other
hematinics.8
The
importance
of dietary
recognized
several
years
ago
been
C.
infections
and
parasitic
infestations.
protein
therapy
alone
unless
the diet
hematinics
made
with
Reference
Woodruff,5
of
of anemia
multiple
Special
in the
Metabolism
manifestation
difficulty
genesis
with
tercurrent
to high
M.
malnutrition.
emphasized
in the
sociated
S. K. SooD,
Deficiency
of
is not
very
similar
only in protein
this experimental
of protein
communication
to the disturbances
role
deficiency
we
present
in iron
per
the remetab-
olism.
From
Delhi,
the
Department
Submitted
S. K.
All
of
Pathology,
1964;
accepted
M.Sc.
(PATH):
All
India
Institute
of
Medical
Sciences,
New
India.
India
M.Sc.
Medical
Department
Noc’. 20,
M.B.B.S.,
SooD,
Institute
(PATH).,
of
PH.D.:
Sciences,
New
of Pathology,
Medical
Sciences,
Assistant
Delhi,
All
for publication
Senior
Research
Professor,
India.
India
New
Jan. 25, 1965.
Officer,
Department
Delhi-16,
Department
V.
RAMALINGASWAMI,
Institute
of
India.
of
M.
Pathology,
M.D..
Medical
Sciences,
C.
All
PH.D.
New
of Pathology,
M.B.B.S.,
DEO,
India
Institute
(OxoN):
Delhi,
of
Professor,
India.
421
BLOOD,
VOL.
26,
No.
4
(OCTOBER),
1965
422
SOOD,
Tabl e 1.-Composition
DEO
AND
RAMALINGASWAMI
of Diets
Constituents
in Gm.
Water
Soluble
Group
Group
Sugar
34
46
Casein
protein)
Group
(High
34
Gastroeneterology
fronu
consists
( Manihot
of
monkey
of
small
also
Twenty-four
31
46: 167,
globules
received
young
weigluts
ranged
were
divided
into
or
trols.
in
They
400
it
equivalent
I.U.
to
be
of
of
365
starch
A;
obtained
100
vitamin
and
and
I.U.
from
tapioca
vitamin
D,
of
and
7
3 were
males.
daily.
and
0.5
and
in
both
groups
to
of
diets
iug.
folic
I,
ex-
a
diet
is given
supplements,
described
10
con-
received
vitamin
been
protein
as
group
of
and
nug.
of
served
composition
received
0.5
rendered
amounts
given
have
They
were
which
diet
feeding
groups
B12
which
iuuineral
Their
experiment.
the
The
the
of
the
animals
aninual
both
vitanuin
earlier.21
of
acid
iron
per
in
clay
the
as
a
supplements.
investigations
diet
performed
were
repeated
at
intervals
Hemoglobin
before
tlue
throughout
by
the
tlue
animals
were
placed
experiment.
cyanmetluemoglobin
metluod,
hemato-
count.24
iron:
(Se.Fe)
earlier
simultaneous
technics
of
aninuals
to
of
except
negligible
of
weight
in
17
containing
details
animal
g.
of
Each
body
All
beginning
respects
casein.
the
the
consisted
all
the
numeral
baseline
sonue
of
each
investigations:
Serum
In
Kg.
diets
I
erytlurocyte
of
used.
at
diet
II
animals,
that
Hematologic
2.
1
from
consisted
in
cent
the
tlue
experimental
and
per
sulfate,
following
tlue
agent.
4
METHODS
Kg.
a
identical
per
of
I
Group
diet
calaries
care
mentioned
the
The
a
15
100
ferrous
of
1.
5
were
4
them
nutrients.
contained
preparation
crit
365
vitanuin
monkeys
and
Group
tube-feeding
fed
1 . The
may
on
1
nuade
AND
rhesus
2 Kg.
groups.
other
were
that
table
growing
by
adequate
part
4
15
1964.
pearls
daily
between
two
protein-deficient
form
5
a-tocopherol.
body
the
Calories
-
MATERIAL
It
Mix.
utilissima).
TEach
in
Total
Mixture
protein
‘Sago
cept
Vitamint
II
control)
Reprinted
but
Salt
I
(Low
mg.
Sago’
Peanut
Oil
Ramsay’s25
studies,
technic
a modified
deternuinations
on
using
2:2
of
William
technic
different
samples
by
dipyridyl
as
and
Zak2#{176}was
both
technics
the
coloring
re-
used.
gave
Several
comparable
values.
3.
Serum
4.
Total
unsaturated
serum
Spinco
mans
5.
lron
and
to
serunu
g.
iron
et
with
acid.
No
olism
cages
2
cent
per
in
50 g.
of
or
of
by
overnight
and
elemental
the
This
for
the
Troiuuhay,
for
fasted
administering
modified
sc),
food
(Rcssler
& Zak).27
electropluoresis
using
Beck-
dose
of
during
the
iron
was
given
iron
and
at
test.
Ferrous
orally.
1,-3-and
sulphate
Serum
samples
7-hour
intervals
estimated.
al.29
Establishment,
tube
were
nonradioactive
absorption:
4000
=
of
before
Radioiron
Bonnet
iuug.
(UIBC)
Fractionation
capacity:
technic.28
apparatus.
Animals
25
obtained
6.
binding
Biuret
electrophoresis
tolerance:
equivalent
were
iron
proteins:
the
the
form
Bombay,
carrier
iron
nueasured
monkey.
of
given
Stools
administered
using
FeCl3
solution,
India.
Two
for
the
Radioiron
nonradioactive
was
test.
was
the
next
were
collected
dose.
This
was
tenths
iron
the
as
iron
ferrous
until
fecal
of
obtained
c.
8 hours.
was
Fe59
(Fe59)
achieved
method
of
specific
activity
(1
from
the
animals
fecal
in
Atomic
administered
and
300 nug.
sulfate
The
the
was
recovery
high
were
radioactivity
most
of
kept
fell
the
animals
Energy
by
stomach
of
ascorbic
in
to
metabbelow
in
3-4
ANEMIA
IN
EXPERIMENTAL
PROTEIN
Table
423
DEFICIENCY
2.-Hematologic
Value8
in
Deficient
Animals
Weeks
Basal
(14)’
Investigation
Hematocrit
(%)
Gm.
%
RBC
(x
106/mm.3)
MCV
(s)
42.2
(32-54)
12.6
10.4
(7.5-13.4)
5.9
(4.12-7.20)
MCH
(g.)
MCHC
P test
Basal
and
8-10
#{176}Nui,uher of
days.
Entire
t’rated
nitric
a well-type
7.
Bone
anesthesia
4.59
3.86
(3.49-4.25)
78.7
88.7
(51.3-102.8)
(52.3-96.0)
(8.7-94.1)
24.4
23.5
Mean
21.4
Range
(13.7-25.7)
(21.4-27.0)
(14.3-18.5
27.5
Mean
29.3
Range
(25.2-31.5)
(26.8-34.3)
(25.8-29.4)
Hematocrit
Hemoglobin
RBC
%
tand
9.4
(8.5-11.5)
(3.46-5.84)
73.4
Mean
Range
34.2
(30-39)
(10.1-14.6)
Mean
Diet
15 weeks
(4)’
(28-44)
Mean
Range
Protein
34.9
Mean
Range
Range
Hemoglobin
on Low
8-10 weeks
(14)’
weeks
30.0
n=13
n=13
t = 3.279
n=13
p<0.001
p<0.001
p<0.01
4.586
t =
5.238
t =
aninuals.
stools
were
acid.
A
scintillation
to a pyrex
aliquot
was
taken
glass
in
a
beaker
and
standardized
digested
test
tube
using
and
concencounted
in
center.
Marrow:
from
transferred
2-ml.
tlue
Specimens
were
iliac
at
crest
obtained
the
end
tinder
of
tlue
sodium
pentoharbitone
experiment.
methanol
and stained
by
Leishman
Stain
and by Perl’s
8. All animals
were sacrificed
at the end of the study
and bone marrow
examined
for stainable
iron.
The
(Nembutal)
smears
were
fixed
in
reaction.30
and
sections
of
the
liver,
spleen
RESULTS
Hcmalologic
All
Studies
protein-deficient
between
8 and
significant
fall
animals,
10 weeks
in
and at 8-10
weeks
tively.
Hemoglobin
except
of
12 out
1, developed
deficiency
of
14
(table
animals.
of deficiency
concentration
was
The
moderately
2).
mean
42.2 per cent
and
erythrocyte
icantly
decreased
(table
2). Further
observations
of deficiency
indicated
a continued
fall in hematocrit,
tion and erythrocyte
count
(table
2). In 2 deficient
fed a high
protein
diet
for 8 weeks
the anemia
The anemia
encountered
in the deficient
animals
chromic.
The
MCHC
remained
almost
constant
experiment.
however,
not
show
MCV
these
any
and
changes
significant
MCH
were
were
not
change
slightly
raised
statistically
in
hematologic
The
severe
hematocrit
hematocrit
value
and 34.9 per
count
were
in
anemia
showed
a
initially
cent,
also
respecsignif-
4 animals
at 15 weeks
hemoglobin
concentraanimals
which
were
re-
was
completely
corrected.
was normocytic
and normothroughout
the period
of
in protein-deficient
significant.
indices
The
animals;
controls
throughout
did
the
424
SOOD,
Table
3.-H
ematologic
Values
Mean
Range
Hemoglobin
Mean
Gm.
Range
%
(x 106/num.3)
1.969;
t6 =
Table
of
Animals
12.7
13.3
(12.3-15.8)
6.5
5.4
(5.45-8.42)
(3.59-6.75)
0.1
lron
and
lron
Binding
Capacity
in
Protein-Deficient
Basal
(12)’
iron
U.I.B.C.
Mean
172
113
(83-308)
(70-177)
Mean
T.I.B.C.
269
Mean
441
346
(275-547)
(314-394)
p Test
and
t1111
Only
for
Iron
3.388
=
Number
of
experiment
were
marrow
altered.
animals
Serum
Iron,
and
Iron
iron:
ig.
per
marrow
Binding
The
cent
No
showed
giant
fasting
(table
Se.Fe
of Se.Fe
due
Paired
Observatieszs
T.I.B.C.
4.596
=
deficient
t(11)
7.228
=
P<0.001
observed
in the
serum
iron
4). All
at 8-10
a definite,
uniform
and
or
5).
The
and
showed
was
progressive
and
were
activity.
Iron
Absorption
fall
could
lower
be
showed
consistent
capacity
reduction
in
the
pro-
except
1, showed
The
mean
value
significantly
animals
most
myeloid
a progressive
change
binding
normoblastic.
metamyelocytes
erythroid
Serum
stage
iron
was
erythroid,
the deficient
animals,
weeks
of deficiency.
cent.
This
diet.
the control
total
the
on smears
and sections,
was
not
slightly
raised
in the protein-de-
to reduced
of
at this
animals
in
erythroblasts
Capacity
tions in the level of Se.Fe
(table
Serum
Iron
Binding
Capacity:
was
of
abnormalities
is probably
basal
value
of 172 #sg. per
the animals
a high
protein
In comparison
with
this,
ment
285
(193-347)
P<0.0O1
cellularity,
as examined
The
M.E.
ratio
was
tein-deficient
animals
marked
reduction
in
111.4
The
morphologic
elements.
ficient
Serum
3).
no
megakaryocytic
seen.
The
appreciably
174
(106-272)
animals.
(table
There
111.4
the
t(11
Weeks
(12)’
(75-175)
U.I.B.C.
P<0.01
=
8-10
(164-296)
Range
weeks
Diet
234
(140-344)
Serum
8-10
Animals
Protein
4 Weeks
(6)’
Range
Range
and
Protein
42.7
(38-45.0)
Low
Basal
High
(7)’
animals.
4.-Serum
Serum
Weeks
Diet
(11.3-14.2)
Mean
P <
8-10
43.7
(39-50)
Range
#{176}Number
RAMALINGASWAMI
Basal
(7)’
Henuatocrit
%
RBC
AND
in Control
Investigation
RBC
DEO
than
reversed
no
change
all
mean
refeeding
significant
(TIBC)
in
the
by
altera-
in this
experi-
of serum
which
the
protein-dc-
a
of
ANEMIA
IN
EXPERIMENTAL
Table
PROTEIN
5.-Serum
iron
425
DEFICIENCY
and
iron
Binding
Capacity
in Control
Basal
Investigation
Serum
Fe(j.cg.%)
Animals
8 to 10 Weeks
High
Protein
Diet
(6)’
(6)’
179.3
211.1
(128-250)
U.I.B.C.
(pg.
T.I.B.C.
%)
(zg.
(96-263)
292.3
289.8
(104-384)
(120-400)
%)
471.6
509.0
(336-527)
Serum
iron
T.I.B.C.
Nunuber
=
*
:
(346-628)
: t151
=
0.761
P <0.5
t(5)
=
0.638
P <0.5
of aninuals
ficient
monkeys
( table 4) The reduction
in TIBC
was severe;
its value
falling to almost
2A of the basal
value
at 8-10
weeks
of deficiency.
The
UIBC
also showed
similar
alterations
( table 4 ) These
changes
could
be reversed
in
the 2 protein-deficient
animals,
refed
a 15 per cent
casein
diet for 8 weeks.
.
.
In
contrast,
the
control
animals
showed
no
significant
changes
in
TIBC
and
UIBC.
Plasma
Iron
tained
on
served
between
at the
end
the
Tolerance:
stock
diet,
1 and
of 7 hours.
basal
value.
The iron tolerance
1). The
animals
In
the
preliminary
highest
The
The
in plasm
rise
tended
curves
returned
to
3 control
animals
significant
alterations
Fe59 Absorption:
from
Absorption
and
in
4 control
monkeys.
iron
and
of iron
absorption
values
in 7 out
in
only,
basal
iron
flat
reached
204.5
healthy
after
to fall
was
8 weeks
at
generally
after
per
/Lg.
the
cent
(fig.
was
basal
to
11/2
31/2
animals
test
on
obvalue
times
(fig.
dose
in deficient
the average
at 4
lower
than
the mean
basal
in the diet in 2 animals,
1).
The
periods
of
of protein
from
9 per
(table
6).
main-
iron
in protein-deficient
similar
weeks
monkeys
oral
to nearly
values
were
seen.
of iron using
Fem was
8-10
ranging
of 9 animals
tended
on
iron
were
significantly
replenishing
protein
normal
At
level
to be
highest
levels
of plasma
were
258.3
,Lg. per cent
curves
studied
of plasma
3 hours.
and 8 weeks
of deficiency.
These
value
of 388.7
g.
per cent.
On
the
studies
level
iron
studied
deficiency,
cent
to 23
In 1 animal,
tolerance
dietary
was
regime.
in
there
per
cent
over
the absorption
No
9 deficient
was
a fall
the basal
was not
affected
and in another
there
was a rise of 6 per cent at the end of 10 weeks
of protein
deficiency.
The average
value
for iron absorption
in the deficient
group
was 39.9 per cent
as compared
to the basal
value
of 50.8 per cent.
The
which
changes
fall
in absorption
were
fed a high
were
observed
Serum
Proteins:
protein-deficient
protein
and
in the
The
animals
albumin
was
protein
significant
diet
for
(table
7).
changes
showed
fraction
statistically.
a comparable
in serum
a marked
(fig.
In
proteins
were
and consistent
2).
4 control
period,
no
very
fall
in
animals,
significant
striking.
total
The
serum
426
SOOD,
BASAL
(UCAN:_
38$
IIEI4WEEKS
LOW
EJ8WEEKS
LOW-PROTEIN
REFED
116
127
Fig.
1.-Iron
tolerance
The
end
fall was
8 weeks,
of
in total
beta
globulins
globulins
monkeys
tein
and
fraction
markable
and
(No.
8
weeks
119
and
progressive
as
the concentration
fallen
from
basal
levels
Gm. per cent and
1.21
rise
4
204
FOR
5$#{176}Io)
BWEEKS.
130
134
the
not
due
show
of
protein
154)
which
albumin
were
refed
returned
remained
variation
high.
from
duration
of total
bar
iron.
deficiency.
showed
Refeeding
prolevels.
of
a
of these
increased.
At the
and albumin
had
3.87 Cm. per cent
to 5.24
There
was a quantitative
globulins.
alteration.
animals
used
basal
value.
maximum
animals
in restoration
in gamma
significant
shows
All
of deficiency
serum
proteins
a diet containing
to original
basal
Three
the
154
Each
oral
resulted
to a rise
any
119
NUMBER
of 7.24 Cm.
per cent
and
Gm. per cent,
respectively.
solely
did
DIET
protein-deficient
animals.
a test close of 25 mg.
of
in
RAMALINGASWAMI
:_2583)19#{176}/o)
(MEAN-
172
MONKEY
level of serum
iron following
lowering
of peak levels at
tein rich diet
to 2 animals
(MEAN
PROTEIN
162
AND
7,4L4)
PROTEIN
HIGH
DEO
In
15 per
value,
cent
but
as controls
The
alpha
and
2 protein-deficient
casein,
the
the gamma
did
not
total
proglobulin
show
any
re-
DISCUSSION
In
the
present
produced
experiment
in rhesus
all other
ing been
monkeys
nutrients.
studied
Each
before
Furthermore,
the
keys by replenishing
significant.
the
changes
deficient
dietary
The
controls
protein.
may
by
feeding
reversal
of
dietary
protein,
on
in
be
the
isocaloric
deficient
reasonably
protein
them
monkey
served
and
at intervals
successful
their
observed
group
uncomplicated
a diet
as its own
during
changes
makes
and
group.
attributed
deficiency
adequate
has
in calories
and
control,
each
animal
the feeding
of test
havdiets.
in 2 protein-deficient
the observations
high
protein
The
been
changes
specifically
diets
did
even
monmore
not
show
observed
to
deficiency
in
the
of
ANEMIA
IN
EXPERIMENTAL
Table
PROTEIN
427
DEFICIENCY
6.-Absorption
of Fe5#{176}
in Protein-Deficient
Monkeys
% of Orally
Administered
8-10
Serial
Number
Monkey
Basal
Number
1.
2.
Fe’5
Weeks
of Protein
Deficiency
4.
5.
6.
7.
284
313
348
350
351
353
358
54.7
29.0
34.0
64.0
40.0
61.0
58.0
8.
361
59.0
43.8
36.8
56.0
35.7
60.0
9.
370
58.0
45.0
3.
22.7
50.8
Mean
t(8)
Table
35.0
35.0
7.-Absorption
=
2.91
of
Fe59
39.9
P <
in
Control
0.02
Monkeys
10 Weeks
Serial
Number
Monkey
Number
Basal
2.
359
360
35.4
65.0
3.
362
58.0
4.
379
30.0
1.
Mean
47.6
0.32
=
Diet
36.0
56.0
60.0
36.0
45.6
t(3)
of High
Protein
P <
0.8
Anemia
Moderate
anemia
developed
of protein
restriction.
marked
atrophy
of
and
gastrointestinal
in these
marked.
At
organs
tract,
animals.2123
This
is in
In
Kwashiorkor,
is
the
The
Wintrobe17
in
who
deficient
The
This
may
therapeutic
be
protein,
like
inics
other
than
tein
deficiency
in this condition.
is
the
diet
reported
variable
plays,
if at
However,
turnover
change
in
at
and
can
study,
of
which
is adequate
per se causes
only
are in agreement
swine
microcytic
iron6
in
such
the
end
of 8 weeks
plasma
albumin,
as the pancreas
liver
are present
these
changes,
the
anemia
was
Whipple’s
work
which
indicates
present
a species
response
at the
reduction
preferentially
in protein-deficient
Aschkenasy,
rats.
reported
to
with
anemia
finding,
of animals
severe
protein
fatty
maintained
in monkeys
fed a low protein
indicates
that protein
deficiency
mic anemia.
These
observations
and
time,
high
severe
Compared
conformity
hemoglobin
synthesis
body
proteins.31
type.3’#{176}’7’1244
in a majority
this
with
and
but
are
the
be
only
or folic
acid,7
all, a minor
role
in
it is now recognized
of
any
one
of
other
morphologic
type
at
variance
of
with
anemia
of Kwashiorkor
has
as
that
anemia
in all other
hematinics
a normocytic
normochrowith
those
of Cartwright
hypochromic
difference.
of the anemia
expense
not
lead
to a belief
the pathogenesis
that
the anemia
those
in
of
proteinto hematthat
pro-
of anemia
of Kwash-
428
SOOD,
DEO
AND
RAMALINCASWAMI
I
3
0
z
0
3Q
-
A.G
RATIO
__________________________________
DURATION-a
NO
MONKEYS
Fig.
USED-
iorkor
of
and
responds
B12 unless
protein
protein
A:G
levels
diet
the
In
in
depletion.
ratio,
to
treatment
be completely
corrected
focus
the importance
of
fall
seemu.
iron,
folic
pr0tein.
to
in
initially
imu total
camu be
with
with
Kwashiorkor
experiment,
animals,
progressive
in y-globulimu
is supplemented
anemia
of
the present
protein-deficient
A
amud a rise
inadequately
the
sponse
of
reported.8
into
serum
8 weeks
albumin
serum
could
7
2.-Mean
4 and
at
0
BWEEKS
WEEKS
OF
acid
Recently,
a high
protein
2 protein-deficient
by protein
repletion.
protein
deficiency
or
vitamin
therapeutic
diet
These
se
per
and
proteimus,
serum
in
alone
animals,
re-
luas been
anemia
observations
bring
the causation
of
anemia.
iron
It
Metabolism
is interesting
deficient
In human
values
and
fall
The
to
monkeys
cases,
the
levels
Se.Fe
in
significantly
similarity
altered
between
and
strongly
protein
stage
of
synthesis
The
fall
reserves,
poiesis.14
erythropoiesis
low
was
saturation
the
other
that
the
due
to
results
suggest
a
serum
failure
There
of
was
the
iron
in
close
cent
in
The
can
Se.Fe
and
were
reported
fall in TIBC
fall
and
our
of
in
be
due
TIBC
may
(transferrin
to
protein-deficient
transferrin
iron
to
define
be
)
due
protein-
Lahey
et al.15
therefore,
the
between
monnot
remarkable
on Kwashmetabolism
in
to
was
the
a
present
diminished
.
decreased
of iron
from
stores
either
of depletion
experiment.
by
and,
The
data
is difficult
in
in
Kwashiorkor.15’16
of the normal
Se.Fe.
reported
the
inter-relationship
fall
protein
TIBC
reported
in
to one-fourth
raised.
In
saturation
comparable
monkeys
relationship
mobilization
no evidence
present
was
per
a
The
our
knowledge.
of the iron-binding
in
changes
as 78 peg. per cent
as severe
as the
not
of transferrin
hand,
the
deficiency.
in
the
similar
to those
recently
TIBC
falls to about
one-half
as
i’
cent
keys,
on
iorkor
note
are
absorption,
or
of
poor
iron
increased
erythroiron or of increased
IN EXPERIMENTAL
ANEMIA
iron
The
plasma
iron
several
the
curve
plasma
iron,
may
be
absorption.
iron
due
The
and
fection33
in
studies
support
this
enriched
reported
was
concluded
ficiency.3”
the
that
an
the
oral
dose
plasma
showed
some
is known
therefore,
deficiency.
are
of
inin-
evidence
to be
that
The
of
or low
rapid
clearance
no obvious
focus
marrow
appear,
protein
excess
of
recovery
the
the
Fe59
based
They
of Fe5”
in
as the
By
of
depressed
flat
curves
absorption
was
various
tissues
it
protein
and
de-
with
criticism.
malnutritional
of measuring
diets
Bothwell
siderosis,
iron
of
protein
in
to
effects
a low
observations,
increased
open
of
in
these
evidence
therefore,
method
iron
of
indirect
4 cases
the
feeding
of
basis
iron
on
are,
absorption
the
of
are
regarding
iron.
deposition
On
absorption
iron.
literature
of
salts,
excessive
workers.3941
the
iron
in
absorption
conclusions
studied
fecal
the
with
iron
by several
containing
would
in
exists
on
These
produce
was
erythropoiesis
bone
from
hypothesis.
malnutrition
al.42
and
by the
uncertainty
diet,
was
There
animals.
There
since
any point
its clearance.35’36
after
of iron
which
animals
deficient
curves,
and
monkeys
clearance
of Fe59
rats.38
It
absorption
lowered
Considerable
protein
protein-deficient
a rapid
conditions
erythropoiesis.37
uptake
protein-deficient
a
the
to
deficient
The
indicate
in
either
common
increased
our
depression.
et
429
curves
were
flat in the
the interpretation
of these
of the rate of iron absorption
in
is a resultant
low
fection
tolerance
limitations
The
in
DEFICIENCY
Absorption
are
on
PROTEIN
using
absorption.
They
concluded
that
iron
absorption
was
lowered
in these
cases.
More
recently,
Higginson
et al.’8 and
Kiavins
et al.43 presented
evidence
to indicate
that
iron absorption
was, in fact, decreased
in protein-deficient
rats.
These
results
are
in
with
agreement
Mechanism
The
anemia
acid.
It
over
such
observed
has
of young
a result
in
data
presented
here.
of Anemia
normochronic.
The
tivity.
It is unlikely
organ
the
as
been
the
in the
marrow
to be
protein-deficient
monkeys
was
normoblastic
due to a deficiency
shown
in this
gastrointestinal
laboratory
tract,
that
spleen
animals
undergo
marked
atrophy
of decreased
cellular
proliferation.23
with
high
erythropoiesis
liferation
may
cell
in
thus
turnover.
rats
on
be
an
normocytic
organs
with
and
growing
and
erythroid
B12 or
high
ends
in protein
deficiency
The
bone
marrow
Bethard
et al.44 have
protein-deficient
diets.
important
was
with
reduced
of iron,
vitamin
acfolic
cell turnof bones
probably
is also
shown
drastic
reduction
Decreased
cellular
pro-
mechanism
of
anemia
in
protein
deficiency.
SUMMARY
1. This
investigation
Rhesus
monkeys.
in
2. Protein
given
deals
deficiency
a protein-rich
was
diet,
with
a study
induced
served
in
as
of the
17
controls.
rhesus
The
as
an
anemia
of protein
monkeys.
diets
of
deficiency
Seven
animals,
both
the groups
430
SOOD,
were
identical
ensure
all
in
adequate
Hematocrit,
plasma
recovery
experiment
in both
except
erythroctye
iron
method
total
proteins
all deficient
also observed.
curves,
studied
and
monkeys
of moderate
All
count,
tolerance
were
deficient
Protein-deficient
protein.
AND
RAMALINGASwAMI
animals
were
tube-fed
serum
iron
to
intake.
hemoglobin,
ing capacity,
F&”
fecal
anemia
respects,
caloric
DEO
control
developed
A striking
.
and
albumin
with
animals.
A significant
The
Fe5” absorption
fall
normocytic
serum
in
a rise in gamma
and
comparable
was
depressed
of plasma
iron tolerance
curves.
diet,
showed
reversal
of all these
iron,
bind-
iron
absorption
using
and
at intervals
of
the
the
groups.
consistently
severity
serum
and
before
Two
deficient
changes.
The
of these
changes.
The
mechanism
of anemia
and decreased
protein-deficient
animals
and
the
relevance
normochromic
iron
binding
capacity,
globulin
was
observed
in
fall in serum
iron
was
and
there
was flattening
animals,
control
refed
animals
a high
protein
did not show
any
Kwashiorkor
are
1. Le
hic-reportate
studio
in macacas
2. Carentia
de
proteina
recipeva
A parte
recipeva
le proteina,
br alimentation
un
caloric.
Le hematocrite,
le nivello
tolerantia
le uso
ante
de
del
ferro
como
a carentia
normochromic
clino
teinas
del capacitate
e de albumina,
in
parabile
Fe5#{176}
esseva
omne
dicta
In
rica
terationes.
de
iste
duo
in
prOteina
Le
animales
Es discutite
observate
in
ferro,
le
the
in
concernite
inducite
con
Ic
anemia
e serviva
dcl duo
intubation
a carentia
de
hemoglobina,
a identification
de
durante
jib,
de
controlo.
de
proteina
de
moderate
ferro-ligatori
con
un
grados
del
de
controlo
respecto
in
de
controlo.
identic.
Le
adequate
animales
ingestion
le curvas
absorption
le feces)
de
esseva
Un
a carentia
frappante
proteina,
reversion
non
monstrava
omne
le
de
ille
ulle
reducite
si ben
clinic
Le
del
pro-
oh-
e com-
absorption
plasma
de
esseva
be transferimento
de
anemia
e dcl
de proteina
de-
seral
de
esseva
significative
observate.
pro ferro
de
(con
normocytic
Un
del total
contentos
del globulina
gamma,
proteina.
ferro
determinate
in le gruppo
severitate.
altere
erythrocy-
sero,
uniformememte
de
un
al tableau
de
del
tanto
esseva
etiam
de tolerantia
a carentia
resultava
con
sero,
augmento
Ic ferro
seral
e le curvas
de
in
disveloppava
a carentia
animales
Fe5”
Septe
gruppo
le numeration
del
e a intervallos
in le gruppo
un
ferro-ligatori
e le intensitate
rhesus.
como
gruppos
esseva
pro assecurar
de
plasma,
17 macacas
in
proteina
in
le mechanismo
del
animales
a carentia
constatationes
INTERLINGUA
Ic capacitate
le animales
declino
in
deprimite,
applattate.
nc
dietas
per
etiam
anemia
servate
le
del
methodo
Animales
esseva
esseva
dicta
de
Ic experimento
proteina
IN
Ic concentration
seral
pro
in
those
rhesus.
animales
tic,
absorption
observed
these
findings
to
discussed.
Su1NfA111o
proteina
iron
of
a un
mentionate
al-
phenomenos.
absorption
como
le
in Kwashiorkor.
de
signification
ferro
ANEMIA
EXPERIMENTAL
IN
PROTEIN
431
DEFICIENCY
ACKNOWLEDGMENT
The
of
autluors
are
iron
and
serum
grateful
to
iron
Dr.
Luna
binding
Banerji
for
help
rendered
by
her
in
estimation
capacity.
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