The metabolic processes of folic acid and Vitamin B12 deficiency Mahmood L - J Health Res Rev
Overview of vitamin B12 and folate deficiencies and tests used to diagnose and monitor these conditions. Food sources: Vitamin B12 is found naturally in animal products (such as fish, . Folate, vitamin B6, and B12 intakes in relation to risk of stroke among men. When it comes to folate and vitamin B, maintaining the proper ratio of these two nutrients can prevent you from masking a potentially dangerous deficiency.
Patients with a recent history of H. Pregnant females were excluded due to their physiological state and contraindication of the urea breath test. Patients with a history of folic acid and B12 supplementations during the six months prior to the study were also excluded.
What Is the Relationship Between Folate & Vitamin B12?
A total number of 14 patients were excluded on the basis of above mentioned criteria. In the study, we did not include healthy Pakistani adults as a negative control group because 3 studies on healthy adults in Karachi over the past few years provided us with sufficient evidence about the prevalence estimates of vitamin B12 deficiency, folate deficiency and hyperhomocysteinemia [ 7 - 9 ].
Determination of serum levels of vitamin B12, folate and homocysteine Prior to the gastroscopy, a fasting venous sample of 5 mL of blood was taken to check serum B12 and folate and homocysteine levels. Serum samples were analyzed for folate and vitamin B12 using radio-assays [ 1516 ]. Brief details of these procedures have been given below: Vitamin B12 cobalamin assay: Vitamin B12 cobalamin in serum sample was extracted by using one volume of serum, one volume of 0.
After centrifugation, the clear supernatant solution was neutralized with 0. A reaction mixture for the standard curve contained 0.
After 30 min incubation at room temperature in the dark, the reaction was stopped in each tube by adding 2. Folate PteGlu assay Folate in the serum was assayed using a noncompetitive ligand binding radioassay. Louis, Mo, USA as the binder. A typical reaction contained 0.
After this incubation, 0. Then the reactions were stopped by adding 0.
Radioactivity in the supernatant solution 0. A blank consisting of 0. These counts were subtracted from each reaction. Concentration of methyl-H4PteGlu in the test sample was determined by reference to this standard dose—response curve. The minimum limit of detection for methyl-H4PteGlu by this method is 0. A known amount of cyanocobalamin or methyl-H4PteGlu was added to the human serum sample.
Using the assay for cobalamin or folate, recovery of added vitamin was determined in the sample. For quality assurance in every assay, standard control serum samples obtained from Aga Khan University Hospital Clinical Laboratory containing the vitamin in low and high concentrations relative to the normal range of levels of that vitamin were run along with the standard curve.
Serum samples were screened for homocysteine using a kit method based on fluorescence polarization immunoassay Abbott Laboratories, Ltd. Pylori infection In this study, H. Two biopsy samples were taken from the antrum and body of the stomach using a standard biopsy forceps for histopathological examination. This is an established method for the detection of H.
Patients positive with both methods were regarded as true positive, while those negative with both methods were regarded as true negative. If only one result was positive, that patient was excluded from the study. Patients were divided into two groups on the basis of the presence of H. Univariate analysis was performed by using a chi-square test to assess the difference among the proportions. An independent sample t-test was used to compare the difference of means if the independent variables followed normal distribution, otherwise the Mann—Whitney U-test non-parametric was performed for H.
All p-values were two sided. Results A total of one hundred and thirty two patients 85 males and 47 females fulfilling the inclusion criteria were enrolled in the study. Moreover, low serine level leads to decreased performance of the immune system since serine is involved in antibody formation. It is involved as 5-methyl tetrahydrofolate methionine in the methylation process where the methyl group is transferred to homocysteine to form methionine in the presence of methionine synthase enzyme.
Methionine synthase is one of the only two enzymes known to be Bdependent enzymes. This process depends on both folic acid as well as vitamin B This reaction needs ATP and vitamin B12 and also the presence of methionine adenosyl transferase [Figure 1].
Methionine is also known to be essential for the formation of collagen that is involved in the formation of skin, nails, and connective tissues, and low methionine level has negative effects in these processes and functions.
Thymidylate synthase is involved in catalyzing the transfer of formaldehyde from folate to dUMP in order to form dTMP. Thymidylate synthase It is an enzyme that plays a role in the replication of cells and tissues. From this cycle, the role of folate can be linked to cancer.
How do vitamin B12 and folic acid interact with each other?
Thymidylate synthase is a metabolic poison that is involved in causing functional folate deficiency, and body's cells grow rapidly as a result of increase in DNA synthesis. Many anti-cancer drugs act indirectly by inhibiting DHFR or directly by inhibiting thymidylate synthase. Purine has many important roles in cell growth, division, and development, since it is considered to be along with the pyrimidine base of the DNA helix.
In case of folate deficiency, there is an impairment of functions of purine, which means impairment in production of DNA, and leads to many problems inside the body, since DNA is the basis of every process.
DNA defects affect each part of the body, i. Megaloblastic anemia is described as presence of large-sized red blood cells than normal. It results from the inhibition of DNA synthesis within red blood cell production.
Since DNA synthesis becomes impaired, the cell cycle cannot progress and cell continues to grow without division, which presents as macrocytosis.B12 and Folate
It can be a result of vitamin B12 deficiency and also due to trapping folate, preventing it from doing its normal function. This defect is caused by thymidylate synthesis defective with deoxyuridine triphosphate enlargement. Megaloblastic anemia leads to impairment of RBC, painful tingling of the hands and feet, gastrointestinal problems e. Also, formyltetrahydrofolate synthetase, which is known as domain of C1 tetrahydrofolate synthetase gene, has been shown that it is linked to a high risk of having neural tube defect.
The most well-known type of this defect is "spina bifida," which can lead to many problems and issues, e. According to the spina bifida association, it can also lead to learning disabilities, gastrointestinal disorders, obesity, depression, urinary and bowel dysfunction, tendonitis, and allergies.
Vitamin B12 commonly known as cyanocobalamin is the most chemically complex of all the vitamins. The structure of vitamin B12 is based on a corrin ring, which is similar to the porphyrin ring found in heme, chlorophyll, and cytochrome and has two of the pyrrole rings directly bonded. Cyanocobalamin cannot be made by plants or animals; bacteria and archaea are the only types of organisms that have the enzymes required for the synthesis of cyanocobalamin. Higher plants do not concentrate cyanocobalamin from the soil, and so are poor sources of the substance, as compared with animal tissues.
Vitamin B12 is naturally found in foods including meat especially liver and shellfisheggs, and milk products. Infants adequate intake months: The enzyme methionine synthase needs methylcobalamin as a cofactor. This enzyme is normally involved in the conversion of the amino acid homocysteine into methionine, while methionine, in turn, is required for DNA methylation.
This conversion is an important step in the extraction of energy from proteins and fats. In addition, succinyl CoA is necessary for the production of hemoglobin which is the substance that carries oxygen in red blood cells. In case of vitamin B12 deficiency, the body does not have the ability to produce methionine, which leads to many problems.
Also, the body does not have the ability to produce S-adenosyl methionine which is known as "SAM" product. These impairments lead to many problems and issues.
How do vitamin B12 and folic acid interact with each other? | Vitamin B12 - Sharecare
The body loses its ability to produce the TCA cycle intermediate, succinyl CoA, which will lead to an impairment of TCA cycle as there is reduced conversion of succinate to fumarate, malate, and to the end product of the cycle, which is responsible for providing small amount of energy before going to electron transport chain which is responsible of high energy production. When the fatty acid is oxidized into propionyl CoA, the role of succinyl CoA appears which is known as succinyl CoA precursor, that is then converted to pyruvate and enters the gluconeogenesis cycle.
The most common disease caused as a result of B12 deficiency is pernicious anemia. Pernicious anemia Pernicious anemia is a type of anemia with the term "anemia" that usually refers to a condition in which the blood has a lower than normal number of red blood cells. In pernicious anemia, the body has no ability to make enough healthy red blood cells because it does not have enough vitamin B Without enough vitamin B12, the red blood cells do not divide normally and are too large, and they may have trouble getting out of the bone marrow.
Not having enough red blood cells to carry oxygen to the body may give a feel of being tired and weak. Severe or long-lasting pernicious anemia can damage the heart, brain, and other organs in the body. Pernicious anemia can also cause other problems such as nerve damage, neurological problems such as memory lossand digestive tract problems. People who have pernicious anemia also may be at higher risk for weakened bone strength and stomach cancer. Hyperhomocysteinemia is a medical condition that is characterized by an abnormally elevated level of homocysteine in the blood.
It increases the risk of developing vein and artery diseases. Elevated homocysteine levels might also be a risk factor for the development of many other diseases such as heart attack and stroke, osteoporosis, Alzheimer's disease, ulcerative colitis, and Crohn's disease.