Regulation at multiple levels control the expression of folate transporters in liver cells in conditions of ethanol exposure and folate deficiency

Correlation of Red Blood Cell Morphology with Serum Cobalamin and Folate Concentration in Dogs with Chronic Diarrhea: A Retrospective Study

Background/Objectives: Chronic diarrhea in dogs is a prevalent condition that significantly impacts canine health, often leading to weight loss, dehydration, and malnutrition. Diagnosing and treating chronic diarrhea is challenging due to its multifactorial nature, necessitating collaboration among veterinarians across various specialties. Measuring cobalamin and folate levels is a crucial diagnostic step for all dogs with chronic diarrhea. The role of these vitamins in erythropoiesis is well-documented in human medicine, where deficiencies are linked to erythropoietic disorders and megaloblastic anemia. This study explores the relationship between cobalamin and folate concentrations with hematologic parameters in dogs with chronic diarrhea to develop novel diagnostic methods that facilitate timely decision making. Methods: Forty-seven adult dogs with a history of chronic diarrhea (2019-2023) were included in the study. Upon presentation, complete blood count and measurement of cobalamin and folate concentrations were performed. The correlation of cobalamin and folate levels with erythrocytic parameters, including hematocrit (HCT), hemoglobin concentration (HGB), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and reticulocyte count, as well as morphological changes in the blood smear were examined. Results: Serum cobalamin was significantly correlated with RBC (p = 0.032), HGB (p = 0.006), HCT (p = 0.005), and MCV (p = 0.022). Anisocytosis was significantly correlated with hypocobalaminemia (p = 0.002), while acanthocytosis correlated with normal cobalamin levels (p = 0.046). No correlation was found between serum folate and erythrocytic parameters or morphological changes. Conclusions: These findings emphasize cobalamin's potential role in canine erythropoiesis, highlighting the need for routine evaluation and supplementation when necessary. Conversely, the lack of association with folate suggests it plays a less significant role in this species. These results underscore the importance of complete blood count in the diagnostic investigation of dogs with chronic diarrhea.

Relationship between folate concentration and expression of folate-associated genes in tissue and plasma after intraoperative administration of leucovorin in patients with colorectal cancer

Purpose

The aim of study was to investigate the relationship between folate concentration and expression of folate-associated genes in tumour, mucosa and plasma of patients with colorectal cancer, after intraoperative administration of bolus leucovorin (LV).

Methods

Eighty patients were randomized into four groups to receive 0, 60, 200, or 500 mg/m² LV, respectively. Tissue and plasma folate concentrations were assessed by LC–MS/MS. Gene expression of ABCC3/MRP3, FPGS, GGH, MTHFD1L, SLC46A1/PCFT, and SLC19A1/RFC-1 was determined using quantitative PCR.

Results

The folate concentration in tumour increased with increasing dosage of LV. Half of the patients treated with 60 mg/m² did not reach a level above the levels of untreated patients. A significant correlation between folate concentration in tumour and mucosa was found in untreated patients, and in the group treated with 60 mg/m² LV. The 5-MTHF/LV ratio correlated negatively with folate concentration in mucosa, whereas a positive correlation was found in tumour of patients who received 200 or 500 mg/m² LV. A positive correlation was found between folate concentration and expression of all genes, except MTHFD1L, in patients who received LV. There was a negative correlation between 5-MTHF concentration in plasma of untreated patients and expression of GGH and SLC46A1/PCFT in tumour.

Conclusions

The results indicate the possibility of using the individual plasma 5-MTHF/LV ratio after LV injection as a surrogate marker for tissue folate concentration. Expression of several folate-associated genes is associated with folate concentration in tissue and plasma and may become useful when predicting response to LV treatment.

Electronic supplementary material

The online version of this article (10.1007/s00280-018-3690-9) contains supplementary material, which is available to authorized users.

FASD: folic acid and formic acid — an unholy alliance in the alcohol abusing mother

Alcohol consumption during pregnancy remains a significant cause of preventable birth defects and developmental disabilities; however, the mechanism of toxicity remains unclear. Methanol is present as a congener in many alcoholic beverages and is formed endogenously. Because ethanol is preferentially metabolized over methanol, it has been found in the sera and cerebro-spinal fluid of alcoholics. Toxicity resulting from methanol has been attributed to formic acid. Formic acid is present in significantly higher quantities in the biofluids of alcoholics. These higher levels can be cytotoxic and cause neuronal cell death. However, the adverse effects can be mitigated by adequate levels of hepatic folic acid, because formic acid elimination depends on folic acid. During pregnancy, folate concentrations are at least 2-fold higher in cord blood then in maternal blood, owing to increased folate requirements. The reverse has been demonstrated in pregnancies with alcohol abuse, suggesting downregulation of folate transporters and low fetal folate levels. Moreover, formic acid can cross the placenta and its adverse effects can be mitigated by folic acid. Thus, the combination of low fetal folate levels and presence of formic acid form a potent cytotoxic combination that may play a significant role in the etiology of fetal alcohol spectrum disorder.