Biotin supplementation affects lymphocyte carboxylases and plasma biotin in severe protein-energy malnutrition

We studied the effect of a supplement of biotin (10 mg/d) or a placebo under double-blind conditions on plasma biotin concentrations and lymphocyte propionyl CoA carboxylase (PCC) and pyruvate carboxylase (PC) in 22 children with severe protein-energy malnutrition (PEM) (5 with kwashiorkor, 10 with marasmus, and 7 "sugar babies"). There were significant differences between the malnourished and control subjects only for PCC, although not among the three PEM types. Six of the patients had both PC and PCC activities below the lowest of the normal control subjects; there was no correlation between biotin concentrations and carboxylase activities in individual patients. In response to biotin supplementation, the greatest change in lymphocyte carboxylase activities was detected in patients who had abnormally decreased initial carboxylase activities, but the response was not related to initial plasma biotin concentration. These results indicate that these enzyme deficiencies are the result of a nutritionally determined biotin deficiency, that carboxylases and especially PCC are better indicators of the biotin status in individual patients than is the plasma biotin concentration, and that in some malnourished patients biotin deficiency may be rate-limiting in their nutritional homeostasis.

Agar plate method using Lactobacillus plantarum for biotin determination in serum and urine

An improved agar plate method of biotin bioassay using Lactobacillus plantarum ATCC 8014 and bromocresol purple was established to determine biotin levels in human serum and urine. Samples were treated with 4.5 N H2SO4 to liberate free biotin, autoclaved for 1 h and neutralized by 4.5 N NaOH, then 10 microliters was added to wells in each plate. The biotin levels were measured in 190 serum and 59 urine samples, and the means were 2.7 +/- 0.53 ng/ml and 12.4 +/- 5.56 ng/mg of creatinine, respectively. The intra-assay coefficient varience (CV) were 3.2 (n = 20) and 1.3% (n = 23), respectively. The recovery of biotin added (10 ng/ml) to serum was 110.7%, and to urine was 99.6%. These findings suggest that this assay is sufficiently accurate and reproducible for routine use in the clinical laboratory. The excretion of orally administered biotin was also demonstrated by the method.

Use of bi-level biotinylation for concurrent measurement of in vivo recovery and survival in two rabbit platelet populations

BACKGROUND

The objectives of this research were 1) to determine whether two populations of platelets may be labeled with different levels of biotin and followed concurrently in vivo by flow cytometry and 2) to determine whether the level of biotinylation affects the in vivo platelet recovery and survival.

STUDY DESIGN AND METHODS

Two platelet aliquots were biotinylated under conditions that resulted in either a lower or a higher number of biotin molecules per platelet. After transfusion, the two populations were distinguished and quantitated by flow cytometry.

RESULTS

In five animals, recoveries were 69.8 +/- 27.0 percent for low-biotin platelets and 72.6 +/- 26.7 percent for high-biotin platelets. For each animal, the recoveries agreed closely. Life span, determined by the multiple-hit method, was 2.68 +/- 0.63 days for low-biotin platelets and 2.58 +/- 0.69 days for high-biotin platelets. These values for recovery and life span are consistent with those measured in rabbits by using radioisotope labels.

CONCLUSION

Platelet biotinylation offers a nonisotopic method for direct comparison of alternative harvest and storage conditions. It also offers the potential for simultaneous evaluation of the in vivo characteristics of platelets from at least two donors.

Requirements for biotin are not affected by the combination of copper deficiency and fructose feeding

OBJECTIVE

The objective of the present study was to establish whether copper (Cu)-deficient rats fed a diet containing fructose as their sole carbohydrate source require more biotin than the recommended 2 mg/kg diet when egg-white serves as the dietary protein.

METHODS

Eighty weanling male Sprague-Dawley rats were randomly divided into 8 groups according to type of dietary carbohydrate (starch or fructose), level of Cu (0.6 micrograms Cu/g diet or 6.0 micrograms Cu/g diet) and level of biotin (2 mg/kg diet or 10 mg/kg diet).

RESULTS

Regardless of the level of dietary biotin, Cu-deficient rats fed a fructose-containing diet exhibited growth retardation, anemia, atrophied pancreata, enlarged hearts and similar death rates. The remaining Cu-deficient rats fed fructose were emaciated and sick regardless of dietary biotin levels. The concentration of biotin in serum and biotin content of liver of rats fed fructose were higher than corresponding values from rats fed starch.

CONCLUSION

Cu-deficient rats fed fructose are not deficient in biotin compared to published normal values. Supplementation of 10 mg/biotin/kg diet did not improve morbidity or mortality and therefore was not beneficial.

Clinical evaluation of biotin-binding immunoglobulin in patients with Graves' disease

Biotin-binding immunoglobulin (BBI) was recently identified in human serum and has been suggested to have a significant association with allergic and autoimmune disorders. Attempts were made to evaluate the clinical significance of BBI in autoimmune thyroid disorders. Prevalence of BBI was significantly higher in Graves' disease (47%) than in Hashimoto's disease (8%) and healthy controls (10%). The BBI consisted of heterogeneous subtypes with respect to binding of several immunoglobulin classes. Sera in Graves' disease showed predominantly IgG-binding BBI, whereas healthy subjects had IgM-binding BBI. Thyroid stimulating hormone receptor antibody (TRAb) level was significantly higher in the BBI non-detected group than in the detected group. There was no significant relationship between BBI prevalence and thyroid hormone concentrations, anti-thyroglobulin antibody (TGAb) or anti-thyroid microsomal antibody (McAb) titers. In addition, biotin levels in peripheral blood and red blood cells and biotinidase activity did not differ in the BBI detected and non-detected groups. The present results suggest that BBI is associated with autoimmune dysfunction in Graves' disease.

Antibodies against biotinylated proteins are present in normal human serum

Antibodies against biotinylated proteins have been identified in 10% of individuals tested (6/60). These antibodies bind readily to biotinylated proteins (50% inhibitory concentration = 0.59 mumol/L) but only modestly to free biotin or biocytin. It is unlikely that any clinical consequences occur as a result of these antibodies, because the affinity for free biotin is too low (50% inhibitory concentration = 0.51 mmol/L) to affect the normal level of free plasma biotin, 0.5 nmol/L. The pathogenesis of this antibiotin immune response is unclear. Repeat testing of several individuals 5 months apart indicated that the antibiotin response was stable. In addition, 51 of the individuals tested for antibiotin antibodies were also examined for antiavidin antibodies. Whereas five were positive for antiavidin, only one individual was positive for both antibiotin and antiavidin antibodies. The presence of an antibiotin antibody is unlikely to affect the in vivo use of biotinylated proteins or cells in human subjects because its affinity for biotinylated proteins is modest and the level of biotinylation for in vivo studies is intentionally low. However, these antibodies may affect clinical or laboratory assays based on the biotin-avidin system where an antibiotin antibody may either positively or negatively affect the specific assay.

Pharmacokinetics and saturable blood-brain barrier transport of biotin bound to a conjugate of avidin and a monoclonal antibody to the transferrin receptor

The delivery of biotinylated therapeutics through the blood-brain barrier (BBB) may be facilitated by the use of avidin-based chimeric peptide conjugates. The latter are formed by conjugating avidin to a BBB drug delivery vector, which is a protein that undergoes receptor-mediated transcytosis through the BBB. The murine OX26 monoclonal antibody to the rat transferrin receptor undergoes receptor-mediated transport through the BBB, and previous studies have shown that a [3H]biotin/avidin-OX26 conjugate is effectively transported through the BBB. However, avidin is a cationic protein, which causes a marked increase in the systemic clearance of avidin-based conjugates from the plasma compartment. The present studies describe attempts to elevate the reduced plasma area under the curve (AUC) of [3H]biotin/avidin-OX26 by preloading or coloading with unconjugated OX26 antibody or unconjugated avidin. Both systemic clearance and BBB transport of avidin-OX26 were equally affected by OX26 preloading or coloading; this had inverse effects on the plasma AUC and the BBB permeability surface area product with no resulting change in the fractional delivery of [3H]biotin to brain. Conversely, avidin coloading preferentially reduced brain clearance of the [3H]biotin/avidin-OX26 conjugate, without substantial alteration in the plasma AUC and greatly reduced the fractional delivery of [3H]biotin to brain. In summary, these studies show that the use of avidin-based vectors results in rapid systemic clearance, which causes a reduction in the delivery of [3H]biotin to brain, despite a comparable BBB permeability coefficient for either the unconjugated OX26 antibody or the avidin-OX26 conjugate.

Biotinidase activity in patients with liver disease

To investigate whether biotinidase deficiency may occur in liver disease, we determined biotinidase activity, biotin levels, and organic acids in patients with liver disease. Serum biotinidase activity in patients with liver disease (2.63 +/- 1.40 nmol/min/ml) was significantly lower than in the control group (5.43 +/- 1.06 nmol/min/ml). Serum biotinidase activity in decompensated liver cirrhosis (LC) and hepatoma was significantly lower than in acute viral hepatitis (AVH), chronic viral hepatitis (CVH), and compensated LC. The mean serum level of biotin in decompensated LC (1.8 +/- 0.6 microgram/ml) and hepatoma (1.7 +/- 0.8 microgram/ml) was significantly lower than in the control group (2.5 +/- 1.0 microgram/ml), and urinary excretion of biotin was increased in patients with liver disease, particularly in decompensated LC. Biotinidase activity correlated positively with serum biotin level and correlated negatively with urinary biotin level. Moreover, in four of five patients with severe liver disease the excretion of propionate, lactate, and 3-hydroxybutyrate decreased after biotin supplementation. The data for patients with severe liver disease so resembled those for late-onset multiple carboxylase deficiency that biotinidase deficiency is likely in patients with severe liver disease.

Plasma stability and pharmacokinetics of radiolabeled deferoxamine-biotin derivatives

The extraordinary high affinity of biotin for streptavidin may be exploited in a two-step in vivo approach for delivering radiolabeled biotin derivatives suitable for imaging and therapy to lesion-bound streptavidin-conjugated monoclonal antibodies. Compared to the use of directly radiolabeled monoclonal antibodies, the two-step approach is desirable because of the fast renal clearance of radiobiotin, which reduces in vivo background levels and radiation dose. Deferoxamine binds with high-affinity trivalent metals useful for imaging and radiotherapy. Three deferoxaminebiotin derivatives were synthesized, radiolabeled and their stabilities tested in vitro in dog plasma and in vivo in the dog by an avidin binding assay and high-performance liquid chromatography. Defero-desaminolysyl-biotin (DLB) was unstable, with immediate degradation evident. A plasma enzyme, biotinidase, converts biocytin to biotin. DLB closely resembles biocytin, and analysis of the urine and plasma suggested rapid degradation of DLB to biotin and desaminolsyl-deferoxamine. Defero-biotin, a direct conjugate of deferoxamine and biotin, was similarly tested and found to be more stable. Defero-acetyl-cysteinyl-biotin contains a carboxyl group adjacent to the amide bond cleavage site of biotinidase. In vitro at 24 hr in plasma, defero-acetyl-cysteinyl-biotin was 87% stable, compared to 45% and 15% for defero-biotin and DLB, respectively. The pharmacokinetics of the three derivatives were similar, with 80% of the injected doses found in the urine at 6 hr; however, only defero-acetyl-cysteinyl-biotin was present as the intact moiety.

Distribution of biotin in human plasma: most of the biotin is not bound to protein

Estimates of the plasma concentration of biotin differ considerably. Variation in detectability of biotin bound covalently to protein is one potential source of disagreement. In this study we determined the amount of biotin covalently bound to plasma protein. First, greater than 99% of free and reversibly bound biotin was removed by dialysis; then greater than 90% of covalently bound biotin was released by acid hydrolysis. For plasma samples from 11 normal adults, the ratio of covalently bound biotin to free biotin was 0.15 +/- 0.09 (mean +/- SD). Taking into account the additional biotin that is reversibly bound to protein, this study provides evidence that approximately 12% of total biotin in plasma is covalently bound, 7% is reversibly bound, and 81% is free. We conclude that covalently bound biotin cannot account for the reported sixfold increase in biotin detected after acid hydrolysis. We speculate that the reported increase was an artifact caused by substances produced during acid hydrolysis of plasma.

Biotin deficiency in rats: disturbances of leucine metabolism are detectable early

3-Methylcrotonyl-CoA originates from catabolism of leucine and is normally metabolized to acetyl-CoA. However, in biotin deficiency, reduced hepatic activity of the biotin-dependent enzyme methylcrotonyl-CoA carboxylase causes the enzyme's substrate 3-methylcrotonyl-CoA to be shunted via an alternate pathway to 3-hydroxyisovaleric acid (3-HIA), which is excreted at increased rates in the urine. In a previous study, unequivocal separation in 3-HIA excretion rates between biotin-deficient and control animals was not apparent until d 35 of feeding a diet that induced biotin deficiency. The present study tested the hypothesis that abnormal 3-HIA excretion could be detected earlier in the course of biotin deficiency if 3-HIA were more accurately measured using a method that incorporated an improved extraction regimen, deuterated 3-HIA as internal standard, and unlabeled 3-HIA as external standard. Biotin deficiency was induced in rats by feeding a diet containing avidin; control rats received the same diet and biotin injections. With the more accurate method, unequivocal detection of deficiency was possible in all deficient rats by d 16. This study provides evidence that, in rats, reduction of analytical error allows earlier detection of biotin deficiency and that disturbances of leucine metabolism occur earlier than previously appreciated.

Investigations of N-linked macrocycles for 111In and 90Y labeling of proteins

To simplify the synthesis of macrocyclic chelators, commercially available macrocyclic amines were condensed with halogenated acetic acid to prepare the five chelators 12N4 (DOTA), 14N4 (TETA), 15N4, 9N3 and 12N3. Only 12N4 and 9N3 showed efficient labeling of the free chelator with 111In and 90Y. Serum stability studies at 37 degrees C with In-labeled DTPA, 12N4 and 9N3 showed no loss of label over 2 days whereas, with 90Y, only 12N4 showed stabilities comparable to DTPA. The 12N4 chelator was derivatized by attaching biotin on one N-acetate group to stimulate the attachment to protein. The serum stability for both 111In and 90Y was identical to that of biotin derivatized DTPA and lower than that of the free chelators. Biodistribution studies in normal mice of a model protein (avidin) labeled with 90Y via biotinylated 12N4 and biotinylated DTPA showed identical distribution at 1 day except in bone where the %ID/g for the macrocyclic-conjugated protein (3.4 +/- 0.5, N = 8) was significantly (P less than 0.001) lower than that of the DTPA-conjugated protein (9.4 +/- 0.9, N = 7). In conclusion, macrocycles may be readily synthesized from the macrocyclic amines and several show useful stabilities with In and Y. When N-linked to a protein, the Y biodistribution was found to be superior to that of the corresponding DTPA-coupled protein.

Avidin attachment to biotinylated erythrocytes induces homologous lysis via the alternative pathway of complement

Noncovalent attachment of avidin to the membrane of prebiotinylated red blood cells (RBCs) induces lysis via the alternative pathway of complement (APC). Lysis is not species-dependent; RBCs from humans, rabbits, rats, and sheep were lysed with both autologous and all heterologous sera. Both biotinylated and native cells were not lysed. Lysis was observed at an avidin surface density of about 10(5) molecules per cell. Acylation of avidin prevents lysis and decreases the positive charge of the avidin. Lysis depends on the length of the cross-linking agent used for the biotin attachment to the membrane. An increase in the length of the cross-linking agent was accompanied by an enhancement of the lysis and the agglutination titer of biotinylated RBCs in a solution of avidin. It is suggested that avidin attachment induces some transformations of the cell membrane that lead to the conversion from "APC nonactivator" cells to "APC activator" cells. The interaction of avidin with membrane APC-restrictors (decay-accelerating factors, type 1 receptor for complement, homologous restriction factor, and others), the charge of avidin, and its cross-linking ability in lysis are discussed. It is proposed that membrane rearrangement induced by multipoint avidin attachment to biotinylated membrane is the main reason for avidin-induced elimination of APC restriction.

A new immunochemical assay for biotin

A double antibody technique has been developed to separate free biotin from bound biotin after competitive binding of [3H]biotin and unlabelled biotin to avidin. Antiavidin goat antibody was added followed by the addition of antigoat IgG antibody linked to agarose. Centrifugation separated the free biotin from the biotin bound to the avidin complex. The method was suitable for the detection of the amounts of biotin contained in 100-200 microliters of plasma or 5-10 microliters of urine. Normal values for the concentration of biotin in plasma and urine determined by this assay were 1.27 +/- 0.67 nmol/l and 49.1 +/- 35.7 mumol/mol creatinine, respectively.

Modulation of plasma biotin in the fowl (Gallus domesticus) by oestrogen and ambient temperature

1. Exposure of laying hens to elevated ambient temperatures (30-40 degrees C) resulted in a significant increase in the biotin concentrations in plasma and egg yolk. 2. Exogenous oestrogen administration to immature pullets increased plasma biotin three-fold. The increase was six-fold when the birds were simultaneously exposed to an ambient temperature of 35 degrees C. 3. It is proposed that ambient temperature affects the balance between thyroid and ovarian hormones resulting in increased circulating levels of biotin and deposition of the vitamin in egg yolk.

Plasma biotin levels in neonates

Plasma biotin levels were measured by a new, very sensitive radioligand assay, in 47 normal full-term infants, receiving breast milk and/or different formulas, during the first 3 weeks of life. Exclusively breast fed infants and infants fed with a formula containing 11 micrograms/l biotin had plasma biotin levels of 538 +/- 78 and 502 +/- 117 ng/l, respectively, during the 1st week of life, and 321 +/- 48 and 503 +/- 153 ng/l, respectively, during the 3rd week of life. Infants fed with a formula very high in biotin (300 micrograms/l) had extremely high plasma biotin levels during the 1st week of life (13,741 +/- 659 ng/l) while during the 2nd week of life they showed a tendency towards decreasing plasma biotin levels. These changes of plasma biotin levels during the first weeks of life indicate that the in vivo kinetics of biotin is changing during this period.

Imaging of tumor in patients with indium-111-labeled biotin and streptavidin-conjugated antibodies: preliminary communication

Tumor localization in patients has been achieved through the in vivo use of streptavidin and biotin. In these preliminary studies, the monoclonal antibody HMFG1 was conjugated with streptavidin and 1 mg was administered intravenously to each of 10 patients with documented squamous cell carcinoma of the lung. Two to 3 days later, 111In-labeled biotin was also administered intravenously. No evidence of toxicity was observed. Background radioactivity levels were reduced in liver (1% ID at 24 hr) and kidneys (2%) and in all other normal tissues and blood. Images of lung tumor were obtained in as little as 2 hr following administration of labeled biotin. In eight patients, tumor was detected with labeled biotin alone without the previous administration of streptavidin-conjugated antibody but in three of these patients, the images were improved with the prior administration of conjugated antibody. These results suggest that this approach may improve the tumor-to-normal tissue radioactivity ratios in radioimmunotargeting.

Lipoamidase activity in human serum is due to biotinidase

Lipoamidase, as determined by lipoyl-p-aminobenzoic acid (L-pABA) hydrolyzing activity, and biotinidase in human serum have similar pH profiles, molecular weights, thermostabilities, and are similarly inhibited by p-hydroxymercuribenzoate and not inhibited by phenylmethylsulfonylfluoride. A monospecific polyclonal antibody prepared against biotinidase immunoprecipitated greater than 95% of serum L-pABA hydrolyzing activity and an identical proportion of biotinidase activity. In addition, children with profound biotinidase deficiency (less than 10% normal serum activity) have greatly reduced levels of L-pABA hydrolyzing activity in serum (less than 15% of mean normal activity) and obligate heterozygotes have activities intermediate between that of normal and profoundly deficient individuals. These results indicate that most, if not all, of the L-pABA hydrolyzing activity in human serum is due to biotinidase. Moreover, since the Km of L-pABA hydrolysis by serum is high, it is unlikely that lipoic acid is recycled in the serum by biotinidase.

[Clinical evaluation of serum biotin levels and biotinidase activities in patients with various liver diseases]

In order to evaluate the clinical significance of serum biotin and biotinidase in liver disease, serum biotin levels and biotinidase activities were determined in 83 patients with various liver diseases and 10 healthy controls. Serum biotin levels and biotinidase activities were determined by a simplified lactobacillus plantarum bioassay and liquid chromatography with fluorimetric detection respectively. Serum biotin levels in decompensated liver cirrhosis, hepatoma and fulminant hepatitis were found to be significant low compared with healthy controls, while it was significant high in autoimmune hepatitis. There was no significant difference between serum biotin levels in the other liver diseases and healthy controls. In various liver diseases except for both acute hepatitis and alcoholic liver disease biotinidase activities were significantly reduced than in healthy controls. Serum biotinidase activities were correlated with serum albumin, prothrombin time, ChE and total cholesterol respectively, suggesting that biotinidase activities may reflect the degree of liver damage. These results seem that biotin deficiency may occur in some cases of severe liver diseases.

Evidence for a pathogenic role of omega 6 polyunsaturated fatty acid in the cutaneous manifestations of biotin deficiency

Abnormalities in fatty acid composition have been detected in biotin deficiency in humans and in the rat. However, the pathogenetic role of these abnormalities, if any, in the cutaneous manifestations of biotin deficiency is not clear. In a nutrient interaction experiment, we tested the hypothesis that an abnormality of omega 6 polyunsaturated fatty acid (PUFA) metabolism plays a pathogenetic role in the cutaneous manifestations. Five rats were fed an egg white diet that induces biotin deficiency; these rats developed the characteristic cutaneous abnormalities of biotin deficiency. Five additional rats were pair-fed the egg white diet and received Liposyn [77% linoleic acid (18:2 omega 6)]; these rats did not develop the cutaneous manifestations of biotin deficiency. The two groups had similar decreases in the rates of urinary excretion of biotin, the serum concentrations of biotin, the amounts of biotin in liver, and the hepatic activities of two biotin-dependent carboxylases; the two groups had similar increases in the rates of urinary excretion of 3-hydroxyisovaleric acid. These observations provide evidence that (a) some abnormality in omega 6 PUFA metabolism has a pathogenetic role in the cutaneous manifestations of biotin deficiency and (b) this pathogenetic role can not be explained as a difference in biotin nutritional status due to a biotin-sparing effect of Liposyn.

Effect of aging on intestinal biotin transport in the rat

The influence of aging of biotin intestinal transport was examined in Fisher 344 rats (3- 12- and 24-month old) using a brush border membrane vesicle (BBMV) technique. In all age groups examined, transport of biotin as a function of concentration was saturable in the presence of a Na+ gradient (out greater than in), but was lower and linear in the presence of a choline gradient (out greater than in.). The Vmax of the biotin transport process was found to be significantly (p less than 0.01) higher in 24-month-old rats compared to 3- and 12-month old rats. On the other hand, the apparent Km of the biotin transport system was similar in all age groups. We also measured plasma levels of biotin in the different age groups. The mean plasma levels of biotin in 24-month-old rats was found to be significantly higher than that of 3-month (p less than 0.005) and 12-month (p less than 0.025) old rats. These results demonstrate that aging is associated with an increase in biotin intestinal transport. This increase appears to be due to changes in the activity (and/or number) but not the affinity of the biotin transport system. Furthermore, an increase in plasma biotin levels was observed with aging, which might be a consequence to the increase in the vitamin's intestinal transport.

Indicators of biotin status: a study of patients on prolonged total parenteral nutrition

Plasma biotin concentration and lymphocyte propionyl CoA carboxylase (PCC) and its activation index (the ratio of enzyme activity in cells incubated with biotin to activity in cells incubated without the vitamin) were compared as markers of biotin status in patients on biotin-free prolonged total parenteral nutrition (TPN). Five patients had been on biotin-free TPN for over 1 month when the study was started, and had already developed clinical signs that may be caused by this vitamin deficiency. They had markedly reduced levels of both biotin and carboxylase levels, which increased to near normal levels 4 months after biotin was added to the TPN. They initially presented subnormal plasma zinc concentrations which were normal at the end of the study. Another 4 patients also received biotin-free TPN. After 1 month propionyl CoA carboxylase, which was already below normal in 3 of them at admission, further decreased and became undetectable in 1 of them, who presented clinical deficiency manifestations. The enzyme activation index increased more than twice, although plasma biotin remained normal. When the vitamin was added to the TPN solution, PCC activity increased and its activation index decreased to normal. Plasma zinc concentrations remained normal throughout in this other group of patients indicating that changes of biotin markers are not likely to be related to zinc status variation. Plasma biotinidase, a key enzyme in biotin endogenous recycling, was already subnormal at admission and had become normal at the end of the study, but was not associated with the biotin status.(ABSTRACT TRUNCATED AT 250 WORDS)