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

Abstract

Background/Objectives: The purpose of this study was to investigate whether vitamin B 6 supplementation had a beneficial effect on inflammatory and immune responses in patients with rheumatoid arthritis (RA). Subjects/Methods: This was a single-blind co-intervention study performed at the Division of Allergy, Immunology and Rheumatology of Chung Shan Medical University Hospital, Taiwan. Patients were diagnosed with RA according to the 1991 American College of Rheumatology criteria for RA. Patients were randomly allocated into two groups: control (5 mg/day folic acid only; n ¼ 15) or vitamin B 6 (5 mg/day folic acid plus 100 mg/day vitamin B 6 ; n ¼ 20) for 12 weeks. Plasma pyridoxal 5 0 -phosphate (PLP), serum folate, inflammatory parameters (that is, high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a)) and immune parameters (that is, white blood cell, total lymphocyte, T-cell (CD3), B-cell (CD19), T-helper cell (CD4), T-suppressor (CD8)) were measured on day 1 (week 0) and after 12 weeks (week 12) of the intervention. Results: In the group receiving vitamin B 6 , plasma IL-6 and TNF-a levels significantly decreased at week 12. There were no significant changes with respect to immune responses in both groups except for the percentage of total lymphocytes in the vitamin B 6 group when compared with week 0 and week 12. Plasma IL-6 level remained significantly inversely related to plasma PLP after adjusting for confounders (b ¼ À0.01, P ¼ 0.01). Conclusions: A large dose of vitamin B 6 supplementation (100 mg/day) suppressed pro-inflammatory cytokines (that is, IL-6 and TNF-a) in patients with RA.

Dietary vitamin B6 intake modulates colonic inflammation in the IL10−/− model of inflammatory bowel disease

“…2B). On the other hand, vitamin B 6 supplementation represents an attractive therapeutic candidate for IBD because the vitamin is freely available, inexpensive and does not produce toxicity at moderate levels of supplementation, even for extended periods [17]. Although vitamin B 6 is required in many cellular reactions, we suggest that its involvement in the metabolism of sphingosine and tryptophan represents plausible mechanisms by which availability of this vitamin modulates inflammation [18].…”

Recomendaciones dietéticas en la artritis reumatoide

“…En cuanto a la suplementación con vitaminas del grupo B, no está claro si una dosis de 100 mg/día de vitamina B6 puede suprimir citoquinas pro-inflamatorias, como la IL-6 o el TNF-alfa en pacientes con AR 34 . Aunque sí, los niveles bajos de vitamina B6 observados en la AR pueden ser corregidos con la suplementación de 50 mg de piridoxina durante 30 días, los datos de algunos estudios sugieren que los pacientes con artritis reumatoide pueden tener mayores requerimientos de vitamina B6 que los de una población normal sana 35 .…”

Plasma Pyridoxal 5′-Phosphate Is Not Associated with Inflammatory and Immune Responses after Adjusting for Serum Albumin in Patients with Rheumatoid Arthritis: A Preliminary Study

“…Since PLP may act as a coenzyme for the production of cytokines and other polypeptide mediators during the inflammatory response [21] and low plasma PLP is associated with impairment in the differentiation and maturation of monocyte-derived macrophages and T lymphocytes [17,22], patients with RA experience chronic inflammatory conditions and immune dysregulation which may possibly increase the utilization and metabolic turnover of plasma PLP. In our recently published study, we demonstrated that a large dose of vitamin B 6 supplementation (100 mg/day) could suppress proinflammatory cytokines, IL-6 and TNF-α, in patients with RA [23]. Thus, patients with RA may have higher requirements for vitamin B 6 to cope with the ongoing inflammatory condition and/or immune dysregulation than those without this disease.…”