Pyridoxal Phosphate Decreases in Plasma but not Erythrocytes during Systemic Inflammatory Response

Vitamin B6 supplementation improves pro-inflammatory responses in patients with rheumatoid arthritis

“…A possible explanation might be that the use and turnover of plasma PLP increased or redistributed PLP from plasma to erythrocyte in an acute systemic inflammatory response (Talwar et al, 2003;Gray et al, 2004;Quasim et al, 2005); plasma PLP, therefore, was negatively associated with CRP level in our earlier study, which included critically ill patients (Huang et al, 2005), and in other studies (Friso et al, 2001(Friso et al, , 2004Kelly et al, 2004). However, RA is a chronic rather than acute inflammatory disease; our RA patients had not only adequate but also relatively high plasma PLP concentrations before the intervention (week 0).…”

“…Previous studies (Roubenoff et al, 1995;Galloway et al, 2000;Friso et al, 2001;Chiang et al, 2003;Talwar et al, 2003;Huang et al, 2005;Cheng et al, 2008) have indicated that lower plasma plasma pyridoxal 5 0 -phosphate (PLP) is associated with increased levels of pro-inflammatory cytokine (that is, tumor necrosis factor-a (TNF-a)) and inflammatory markers (that is, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)). Low vitamin B 6 status due to inflammation might be caused by plasma PLP acting as a coenzyme for the production of cytokines and other polypeptide mediators during the inflammatory response (Friso et al, 2001).…”

Vitamin B6 supplementation increases immune responses in critically ill patients

“…In the study of Gray et al (2004), patients who underwent an elective knee arthroplasty had a significant increase in circulatory CRP concentrations and there was a significant fall in plasma PLP concentration but red cell PLP remained stable. This may be that critically ill patients were under severe stress during the systemic inflammatory response, which may have increased the turnover and utilization of plasma PLP, decreased hepatic PLP reserves (Louw et al, 1992), or redistributed PLP from plasma to erythrocyte (Talwar et al, 2003a;Gray et al, 2004;Quasim et al, 2005). Quasim et al (2005), therefore, suggested that direct measurements of red cell PLP are more responsive to supplementation than plasma measurements in the critically ill patients.…”

“…Critically ill patients were under severe stress, inflammation, and clinical conditions, which may increase the utilization and metabolic turnover of plasma PLP or even cause the redistribution of PLP from plasma to erythrocyte (Louw et al, 1992;Talwar et al, 2003a;Huang et al, 2005). It thus would be interesting to know whether a high dose of vitamin B 6 supplement would increase the immune response of critically ill patients.…”

Pharmacorefractory Status Epilepticus Due to Low Vitamin B6 Levels during Pregnancy

“…4. An inflammatory state may have been responsible for both the decrease in plasma pyridoxal-5 -phosphate levels (13)(14)(15) and the development of status epilepticus. In our patient, elevated temperatures, leukocytosis, and a shift in globulins were found when she was in status epilepticus.…”