Interrelationships between the B-vitamins in B12-deficiency neuromyelopathy. A possible malabsorption-malnutrition syndrome

Dastur, Darab K.; Santhadevi, N.; Quadros, Edward V.; Gagrat, Bomi M.; Wadia, N. H.; Singhal, Barkha; Bharucha, E. P.

doi:10.1093/ajcn/28.11.1255

Cited by 13 publications

(3 citation statements)

References 36 publications

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“…One possible explanation could be that the breastfed children had a cobalamin deficiency. Elevated folate concentrations in cobalamin-deficient subjects has been reported earlier (49) and has been explained by the so called "folate trap" mechanism (50). Furthermore, this phenomenon may obscure the assessment of folate status in cobalamin-deficient subjects (51).…”

Section: Discussionmentioning

confidence: 94%

Cobalamin and folate status in infants and young children in a low-to-middle income community in India

Taneja

Bhandari

Strand

et al. 2007

The American Journal of Clinical Nutrition

109

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Background: Population-based data on the prevalence of cobalamin and folate deficiency in India are lacking. Objective: The objective was to measure the prevalence of cobalamin and folate deficiency among children aged 6 -30 mo residing in a low-to-middle income community in North India. Design: Children aged 6 -30 mo (n ҃ 2482) were identified through a community survey in a low-to-middle socioeconomic area in New Delhi, India. Non-fasting venous blood samples were collected before enrollment in another trial. Results:The median (interquartile range; IQR) cobalamin concentration in 6 -11-mo-old children was substantially lower in breastfed (183; 120 -263 pmol/L) than in nonbreastfed (334; 235-463 pmol/L) children. Cobalamin concentrations decreased progressively with increasing age in the nonbreastfed children. Median (IQR) plasma folate concentrations in the 6 -11-mo-old group were higher in breastfed (20.3; 11.7-34.4 nmol/L) than in nonbreastfed (5.3; 3.4 -7.7 nmol/L) children (P 0.001). Folate concentrations decreased with increasing age in the breastfed children. In the nonbreastfed children, folate concentrations increased with increasing age. Low concentrations of plasma cobalamin (150 pmol/L) were detected in 36% of breastfed and 9% of nonbreastfed children (P 0.001). The proportions of children with plasma folate concentrations 5 nmol/L in these 2 subgroups were 6% and 33%, respectively (P 0.001). Conclusions: In north Indian preschool children, cobalamin and folate concentrations were commonly low and were associated with elevated total homocysteine and methylmalonic acid concentrations. Because low cobalamin and folate concentrations have functional consequences, population-based measures for improving cobalamin and folate concentrations need to be seriously considered.Am J Clin Nutr 2007;86:1302-9.

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Section: Discussionmentioning

confidence: 94%

Cobalamin and folate status in infants and young children in a low-to-middle income community in India

Taneja

Bhandari

Strand

et al. 2007

The American Journal of Clinical Nutrition

109

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“…The “KO+F” allowed us to examine the effect of high folate intake on behavioral deficits due to Cbl deficiency. The primary objective of this was to determine whether high folate intake would further deplete Cbl, worsen the CNS manifestations [40,41] and contribute to the behavioral deficits.…”

Section: Resultsmentioning

confidence: 99%

Behavioral alterations are associated with vitamin B12 deficiency in the transcobalamin receptor/CD320 KO mouse

et al. 2017

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Vitamin B12 (cobalamin) deficiency is prevalent worldwide and causes megaloblastic anemia and neurologic deficits. While the anemia can be treated, the neurologic deficits can become refractive to treatment as the disease progresses. Therefore, timely intervention is critical for a favorable outcome. Moreover, the metabolic basis for the neuro-pathologic changes and the role of cobalamin deficiency in the pathology still remains unexplained. Using a transcobalamin receptor / CD320 knockout mouse that lacks the receptor for cellular uptake of transcobalamin bound cobalamin, we aimed to determine whether cobalamin deficiency in the central nervous system produced functional neurologic deficits in the mouse that would parallel those observed in humans. Our behavioral analyses indicate elevated anxiety and deficits in learning, memory and set-shifting of a spatial memory task in the KO mouse. Consistent with the behavioral deficits, the knockout mouse shows impaired expression of the early phase of hippocampal long-term potentiation along with reduced expression of GluR1, decreased brain mass and a significant reduction in the size of nuclei of the hippocampal pyramidal neurons. Our study suggests that the CD320 knockout mouse develops behavioral deficits associated with cobalamin deficiency and therefore could provide a model to understand the metabolic and genetic basis of neuro-pathologic changes due to cobalamin deficiency.

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“…This could have resulted in a reduction in the storage capacity of the liver for this vitamin (Kato, Narita & Kamohara, 1959). In contrast, both total cyanide-extractable and noncyanide-extractable serum vitamin B 12 levels were markedly lower in non-alcoholic patients with megaloblastosis and neuromyelopathy (Dastur, Santhadevi, Quadros, Gagrat, Wadia, Desai, Singhal & Bharucha, 1975).…”

Section: Discussionmentioning

confidence: 77%

The B-vitamins in malnutrition with alcoholism: A model of intervitamin relationships

et al. 1976

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1. The B-vitamin status of fifty-nine patients, mainly from the lower socio-economic classes in Bombay, with a history of chronic malnutrition, and of alcoholism of 1·5–20 years’ duration, was studied before and during treatment, and in relation to their clinical, especially neurological, condition. These patients were divided into two neurological categories: (1) those with peripheral neuropathy (mainly sensory and distal) alone, (2) those with mental changes (mainly confusion and disorientation) also. Both categories frequently showed pellagrous pigmentation and mucocutaneous signs of B-vitamin deficiency.2. Thiamin and erythrocyte transketolase (EC 2.2.1.1) activity, riboflavin, nicotinic acid, pantothenic acid, total and pyridoxal fraction of vitamin B6, folate and total vitamin B12 were estimated in the blood and the cerebrospinal fluid (CSF) of these patients, and also in the blood of sixty-nine control subjects and in the CSF of some of them. The concentrations of all the vitamins, except vitamin B12, were highly significantly lower in the blood of patients of category 1 compared to the controls, and erythrocyte transketolase activity and pyridoxal concentration in patients of category 2 were significantly lower than those of category 1 patients. Blood pantothenic acid and folate concentrations were reduced less consistently.3. Serum vitamin B12 concentration was significantly increased (though within normal range) in the patients compared to the control group, probably because of the moderate hepatic insufficiency (as assessed by liver function tests) in the former.4. The concentrations of thiamin, riboflavin, nicotinic acid and total vitamin B6 were also highly significantly lower in the CSF in patients of category 1 compared with controls. Furthermore, thiamin, nicotinic acid and total vitamin B6 concentrations were significantly lower in patients of category 2 than those of category 1 patients, indicating that CSF levels reflect better the neurological status of these patients.5. There was a moderate increase in the blood concentration of all the vitamins tested, after a relatively poor hospital diet alone. There was a concurrent increase in the blood levels of thiamin, riboflavin, nicotinic acid and pantothenic acid after parenteral treatment with either thiamin or nicotinic acid. The administration of pyridoxine resulted in a significant increase in the blood levels of riboflavin and the pyridoxal fraction of vitamin B6.

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Interrelationships between the B-vitamins in B12-deficiency neuromyelopathy. A possible malabsorption-malnutrition syndrome

Cited by 13 publications

References 36 publications

Cobalamin and folate status in infants and young children in a low-to-middle income community in India

Cobalamin and folate status in infants and young children in a low-to-middle income community in India

Behavioral alterations are associated with vitamin B12 deficiency in the transcobalamin receptor/CD320 KO mouse

The B-vitamins in malnutrition with alcoholism: A model of intervitamin relationships

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