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Iron supplementation does not worsen respiratory health or alter the sputum microbiome in cystic fibrosis Alex H. Gifford, Diana M. Alexandru, Zhigang Li, Dana B. Dorman, Lisa A. Moulton, Katherine E. Price, Thomas H. Hampton, Mitchell L. Sogin, Jonathan B. Zuckerman, H. Worth Parker, Bruce A. Stanton, George A. O'Toole Journal of Cystic Fibrosis Volume 13, Issue 3, Pages (May 2014) DOI: /j.jcf Copyright © 2013 European Cystic Fibrosis Society. Terms and Conditions
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Fig. 1 Diagram of enrollment, allocation, follow-up, and analysis of subjects. Journal of Cystic Fibrosis , DOI: ( /j.jcf ) Copyright © 2013 European Cystic Fibrosis Society. Terms and Conditions
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Fig. 2 Treatment related differences in serum iron and TSAT. Bars and whiskers denote mean differences from baseline and (standard error), respectively. After 6weeks, serum iron increased by 13.7 (5.9)μg/dl for ferrous sulfate but fell by 4.2 (5.7)μg/dl for placebo. TSAT increased 4.7 (1.5) % for ferrous sulfate and fell by 1.8 (1.7)% for placebo. *p<0.05 for comparison of ferrous sulfate to placebo. Journal of Cystic Fibrosis , DOI: ( /j.jcf ) Copyright © 2013 European Cystic Fibrosis Society. Terms and Conditions
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Fig. 3 Relationship between Akron PES and serum hepcidin-25 in CF. The fixed-effect model for serum hepcidin-25 revealed that every ng/ml increase in serum hepcidin-25 above baseline was associated with a 0.04 (0.01) point increase in Akron PES above baseline (p<0.05). 95% confidence intervals for the slope of this relationship intersect PES=5 at 35ng/ml and 115ng/ml for hepcidin-25. Journal of Cystic Fibrosis , DOI: ( /j.jcf ) Copyright © 2013 European Cystic Fibrosis Society. Terms and Conditions
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Fig. 4 Sputum microbiome is unaltered by iron supplementation. The CF sputum microbiome is unaltered by iron supplementation. A) Relative abundance of P.a. as calculated by deep sequencing (P.a. reads/total reads) for sputum samples obtained from 21 subjects while on or off iron supplementation. Sputum from week 6 of Arm 1 and Arm 2 was compared and analyzed for difference by paired Student's t-test. Each symbol indicates an individual sputum sample. Horizontal line indicates the mean and error bars indicate the standard deviation. There is no significant difference in P.a. relative abundance in subjects on or off iron supplementation (p>0.05). B) Simpson Diversity Index (SDI) for sputum samples obtained while on or off iron supplementation for the same samples and by the same method described in panel A. There is no significant difference in Simpson Diversity Index in subjects on or off iron supplementation (p>0.05). Journal of Cystic Fibrosis , DOI: ( /j.jcf ) Copyright © 2013 European Cystic Fibrosis Society. Terms and Conditions
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