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Yang Y, Ke Y, Liu X, Zhang Z, Zhang R, Tian F, Zhi L, Zhao G, Lv B, Hua S, Wu H. Navigating the B vitamins: Dietary diversity, microbial synthesis, and human health. Cell Host Microbe 2024; 32:12-18. [PMID: 38211561 DOI: 10.1016/j.chom.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 01/13/2024]
Abstract
B vitamins are intricately involved in various physiological processes vital for health. Their significance is complicated by the heterogeneous landscape of B vitamin distribution in diets and the contributions of the gut microbiota. Here, we delve into the impact of these factors on B vitamins and introduce strategies, with a focus on microbiota-based therapeutic options, to enhance their availability for improved well-being. Additionally, we provide an ecological and evolutionary perspective on the importance of B vitamins to human-microbiota interactions. In the dynamic realms of nutrition and microbiome science, these essential micronutrients continue to play a fundamental role in our understanding of disease development.
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Affiliation(s)
- Yudie Yang
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China
| | - Yize Ke
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China
| | - Xinyan Liu
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China
| | - Zhidong Zhang
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China; College of Life Sciences, Inner Mongolia University, Hohhot 010070, China
| | - Rongji Zhang
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China; College of Life Sciences, Inner Mongolia University, Hohhot 010070, China
| | - Fang Tian
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Luqian Zhi
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China
| | - Guoping Zhao
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China
| | - Bomin Lv
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China.
| | - Sha Hua
- Department of Cardiovascular Medicine, Heart Failure Center, Ruijin Hospital Lu Wan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Hao Wu
- State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, and Human Phenome Institute, Fudan University, Shanghai 200433, China; Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
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Jones KS, Parkington DA, Bourassa MW, Cerami C, Koulman A. Protocol and application of basal erythrocyte transketolase activity to improve assessment of thiamine status. Ann N Y Acad Sci 2023; 1521:104-111. [PMID: 36719404 DOI: 10.1111/nyas.14962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Thiamine (vitamin B1) is an essential micronutrient required as a cofactor in many metabolic processes. Clinical symptoms of thiamine deficiency are poorly defined, hence biomarkers of thiamine status are important. The erythrocyte transketolase activity coefficient (ETKac) is a sensitive measure of thiamine status, but its interpretation may be confounded where the availability of the transketolase enzyme is limited. Basal ETK activity per gram of hemoglobin provides a complementary biomarker of thiamine status; however, its measurement and calculation are poorly described. Here, we describe in detail the assessment of basal ETK activity, including the calculation of path length in microplates and the molar absorption coefficient of NADH specific to the assay, and the measurement of hemoglobin in sample hemolysates. To illustrate the application of the methods, we present ETKac and basal ETK activity from women in The Gambia and UK. In conclusion, we present a clear protocol for the measurement of basal ETK activity that will permit the harmonization of methods to improve replication between laboratories.
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Affiliation(s)
- Kerry S Jones
- Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Damon A Parkington
- Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | - Carla Cerami
- Faculty of Epidemiology and Population Health, Nutrition and Planetary Health Theme, MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Albert Koulman
- Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Paquette AG, Lapehn S, Freije S, MacDonald J, Bammler T, Day DB, Loftus CT, Kannan K, Alex Mason W, Bush NR, LeWinn KZ, Enquobahrie DA, Marsit C, Sathyanarayana S. Placental transcriptomic signatures of prenatal exposure to Hydroxy-Polycyclic aromatic hydrocarbons. ENVIRONMENT INTERNATIONAL 2023; 172:107763. [PMID: 36689866 PMCID: PMC10211546 DOI: 10.1016/j.envint.2023.107763] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous pollutants originating from petrogenic and pyrogenic sources. PAH compounds can cross the placenta, and prenatal PAH exposure is linked to adverse infant and childhood health outcomes. OBJECTIVE In this first human transcriptomic assessment of PAHs in the placenta, we examined associations between prenatal PAH exposure and placental gene expression to gain insight into mechanisms by which PAHs may disrupt placental function. METHODS The ECHO PATHWAYS Consortium quantified prenatal PAH exposure and the placental transcriptome from 629 pregnant participants enrolled in the CANDLE study. Concentrations of 12 monohydroxy-PAH (OH-PAH) metabolites were measured in mid-pregnancy urine using high performance liquid chromatography tandem mass spectrometry. Placental transcriptomic data were obtained using paired-end RNA sequencing. Linear models were fitted to estimate covariate-adjusted associations between maternal urinary OH-PAHs and placental gene expression. We performed sex-stratified analyses to evaluate whether associations varied by fetal sex. Selected PAH/gene expression analyses were validated by treating HTR-8/SVneo cells with phenanthrene, and quantifying expression via qPCR. RESULTS Urinary concentrations of 6 OH-PAHs were associated with placental expression of 8 genes. Three biological pathways were associated with 4 OH-PAHs. Placental expression of SGF29 and TRIP13 as well as the vitamin digestion and absorption pathway were positively associated with multiple metabolites. HTR-8/SVneo cells treated with phenanthrene also exhibited 23 % increased TRIP13 expression compared to vehicle controls (p = 0.04). Fetal sex may modify the relationship between prenatal OH-PAHs and placental gene expression, as more associations were identified in females than males (45 vs 28 associations). DISCUSSION Our study highlights novel genes whose placental expression may be disrupted by OH-PAHs. Increased expression of DNA damage repair gene TRIP13 may represent a response to double-stranded DNA breaks. Increased expression of genes involved in vitamin digestion and metabolism may reflect dietary exposures or represent a compensatory mechanism to combat damage related to OH-PAH toxicity. Further work is needed to study the role of these genes in placental function and their links to perinatal outcomes and lifelong health.
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Affiliation(s)
- Alison G Paquette
- Seattle Children's Research Institute, Seattle, WA, USA; University of Washington, Seattle, WA, USA.
| | | | | | | | | | - Drew B Day
- Seattle Children's Research Institute, Seattle, WA, USA
| | | | | | - W Alex Mason
- University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Nicole R Bush
- University of California San Francisco, San Francisco CA, USA
| | - Kaja Z LeWinn
- University of California San Francisco, San Francisco CA, USA
| | | | | | - Sheela Sathyanarayana
- Seattle Children's Research Institute, Seattle, WA, USA; University of Washington, Seattle, WA, USA
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Nutraceutical support in heart failure: a position paper of the International Lipid Expert Panel (ILEP). Nutr Res Rev 2020; 33:155-179. [PMID: 32172721 DOI: 10.1017/s0954422420000049] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Heart failure (HF) is a complex clinical syndrome that represents a major cause of morbidity and mortality in Western countries. Several nutraceuticals have shown interesting clinical results in HF prevention as well as in the treatment of the early stages of the disease, alone or in combination with pharmacological therapy. The aim of the present expert opinion position paper is to summarise the available clinical evidence on the role of phytochemicals in HF prevention and/or treatment that might be considered in those patients not treated optimally as well as in those with low therapy adherence. The level of evidence and the strength of recommendation of particular HF treatment options were weighed up and graded according to predefined scales. A systematic search strategy was developed to identify trials in PubMed (January 1970 to June 2019). The terms 'nutraceuticals', 'dietary supplements', 'herbal drug' and 'heart failure' or 'left verntricular dysfunction' were used in the literature search. The experts discussed and agreed on the recommendation levels. Available clinical trials reported that the intake of some nutraceuticals (hawthorn, coenzyme Q10, l-carnitine, d-ribose, carnosine, vitamin D, probiotics, n-3 PUFA and beet nitrates) might be associated with improvements in self-perceived quality of life and/or functional parameters such as left ventricular ejection fraction, stroke volume and cardiac output in HF patients, with minimal or no side effects. Those benefits tended to be greater in earlier HF stages. Available clinical evidence supports the usefulness of supplementation with some nutraceuticals to improve HF management in addition to evidence-based pharmacological therapy.
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High-dose thiamine prevents brain lesions and prolongs survival of Slc19a3-deficient mice. PLoS One 2017; 12:e0180279. [PMID: 28665968 PMCID: PMC5493381 DOI: 10.1371/journal.pone.0180279] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/13/2017] [Indexed: 12/14/2022] Open
Abstract
SLC19A3 deficiency, also called thiamine metabolism dysfunction syndrome-2 (THMD2; OMIM 607483), is an autosomal recessive neurodegenerative disorder caused by mutations in SLC19A3, the gene encoding thiamine transporter 2. To investigate the molecular mechanisms of neurodegeneration in SLC19A3 deficiency and whether administration of high-dose thiamine prevents neurodegeneration, we generated homozygous Slc19a3 E314Q knock-in (KI) mice harboring the mutation corresponding to the human SLC19A3 E320Q, which is associated with the severe form of THMD2. Homozygous KI mice and previously reported homozygous Slc19a3 knock-out (KO) mice fed a thiamine-restricted diet (thiamine: 0.60 mg/100 g food) died within 30 and 12 days, respectively, with dramatically decreased thiamine concentration in the blood and brain, acute neurodegeneration, and astrogliosis in the submedial nucleus of the thalamus and ventral anterior-lateral complex of the thalamus. These findings may bear some features of thiamine-deficient mice generated by pyrithiamine injection and a thiamine-deficient diet, suggesting that the primary cause of THMD2 could be thiamine pyrophosphate (TPP) deficiency. Next, we analyzed the therapeutic effects of high-dose thiamine treatment. When the diet was reverted to a conventional diet (thiamine: 1.71 mg/100 g food) after thiamine restriction, all homozygous KO mice died. In contrast, when the diet was changed to a high-thiamine diet (thiamine: 8.50 mg/100 g food) after thiamine restriction, more than half of homozygous KO mice survived, without progression of brain lesions. Unexpectedly, when the high-thiamine diet of recovered mice was reverted to a conventional diet, some homozygous KO mice died. These results showed that acute neurodegeneration caused by thiamine deficiency is preventable in most parts, and prompt high-dose thiamine administration is critical for the treatment of THMD2. However, reduction of thiamine should be performed carefully to prevent recurrence after recovery of the disease.
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Turck D, Bresson J, Burlingame B, Dean T, Fairweather‐Tait S, Heinonen M, Hirsch‐Ernst KI, Mangelsdorf I, McArdle HJ, Naska A, Nowicka G, Pentieva K, Sanz Y, Siani A, Sjödin A, Stern M, Tomé D, Van Loveren H, Vinceti M, Willatts P, Lamberg‐Allardt C, Przyrembel H, Tetens I, Gudelj Rakic J, Ioannidou S, de Sesmaisons‐Lecarré A, Forss AC, Neuhäuser‐Berthold M. Dietary reference values for thiamin. EFSA J 2016. [DOI: 10.2903/j.efsa.2016.4653] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Katta N, Balla S, Alpert MA. Does Long-Term Furosemide Therapy Cause Thiamine Deficiency in Patients with Heart Failure? A Focused Review. Am J Med 2016; 129:753.e7-753.e11. [PMID: 26899752 DOI: 10.1016/j.amjmed.2016.01.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 01/19/2016] [Accepted: 01/20/2016] [Indexed: 10/22/2022]
Abstract
Diuretic therapy is a cornerstone in the management of heart failure. Most studies assessing body thiamine status have reported variable degrees of thiamine deficiency in patients with heart failure, particularly those treated chronically with high doses of furosemide. Thiamine deficiency in patients with heart failure seems predominantly to be due to increased urine volume and urinary flow rate. There is also evidence that furosemide may directly inhibit thiamine uptake at the cellular level. Limited data suggest that thiamine supplementation is capable of increasing left ventricular ejection fraction and improving functional capacity in patients with heart failure and a reduced left ventricular ejection fraction who were treated with diuretics (predominantly furosemide). Therefore, it may be reasonable to provide such patients with thiamine supplementation during heart failure exacerbations.
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Affiliation(s)
- Natraj Katta
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia
| | - Sudarshan Balla
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia
| | - Martin A Alpert
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia.
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Khounnorath S, Chamberlain K, Taylor AM, Soukaloun D, Mayxay M, Lee SJ, Phengdy B, Luangxay K, Sisouk K, Soumphonphakdy B, Latsavong K, Akkhavong K, White NJ, Newton PN. Clinically unapparent infantile thiamin deficiency in Vientiane, Laos. PLoS Negl Trop Dis 2011; 5:e969. [PMID: 21423705 PMCID: PMC3050987 DOI: 10.1371/journal.pntd.0000969] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 01/21/2011] [Indexed: 11/19/2022] Open
Abstract
Background Beriberi occurs in Vientiane, Lao PDR, among breastfed infants. Clinical disease may be the tip of an iceberg with subclinical thiamin deficiency contributing to other illnesses. Thiamin treatment could improve outcome. Methodology/Principal Findings A cohort of 778 sick infants admitted during one year without clinical evidence of beriberi were studied prospectively and erythrocyte transketolase assays (ETK) performed. Biochemical thiamin deficiency was defined both in terms of the activation coefficient (α>31%) and basal ETK activity <0.59 micromoles/min/gHb. Of the 778 infants, median (range) age was 5 (0–12) months, 79.2% were breastfed, 5.1% had α>31% and 13.4 % basal ETK<0.59 micromoles/min/gHb. Infants ≥2 months old had a higher frequency of biochemical markers of thiamin deficiency. Mortality was 5.5% but, among infants ≥2 months old, mortality was higher in those with basal ETK<0.59 micromoles/min/gHb (3/47, 6.4%) than in those with basal ETK≥0.59 micromoles/min/gHb (1/146, 0.7%) (P = 0.045, relative risk = 9.32 (95%CI 0.99 to 87.5)). Multivariate regression analysis indicated that infant age ≥2 months and fewer maternal years of schooling were independently associated with infant basal ETK<0.59 micromoles/min/gHb. Conclusions/Significance Clinically unapparent thiamin deficiency is common among sick infants (≥2 months old) admitted to hospital in Vientiane. This may contribute to mortality and a low clinical threshold for providing thiamin to sick infants may be needed. Infantile beriberi, or clinical thiamin (vitamin B1) deficiency in infants, is a forgotten disease in Asia, where 100 years ago it was a major public health problem. Infants with this deficiency, commonly aged ∼ 2–3 months, present in cardiac failure but usually rapidly improve if given thiamin injections. It remains relatively common in Vientiane, Lao PDR (Laos), probably because of prolonged intra- and post-partum food avoidance behaviours. Clinical disease may be the tip of an iceberg with subclinical thiamin deficiency contributing to sickness in infants without overt clinical beriberi. We therefore recruited 778 sick infants admitted during one year at Mahosot Hospital, Vientiane, without clinical evidence of beriberi, and performed erythrocyte transketolase (ETK) assays. 13.4 % of infants had basal ETK<0.59 micromoles/min/gHb suggesting biochemical thiamin deficiency. Mortality was 5.5% but, among infants ≥2 months old, mortality was higher in those with basal ETK<0.59 micromoles/min/gHb (3/47, 6.4%) than in those with basal ETK≥0.59 micromoles/min/gHb (1/146, 0.7%) (P = 0.045, relative risk = 9.32 (95%CI 0.99 to 87.5)). We conclude that clinically unapparent thiamin deficiency is common among sick infants (≥2 months old) admitted to hospital in Vientiane. This may contribute to mortality and a low clinical threshold for providing thiamin to sick infants may be needed.
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Affiliation(s)
- Sengmanivong Khounnorath
- Department of Pediatrics, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
| | | | - Ann M. Taylor
- Centre for Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
| | - Douangdao Soukaloun
- Department of Pediatrics, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
| | - Mayfong Mayxay
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Lao People's Democratic Republic
| | - Sue J. Lee
- Centre for Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Bounthom Phengdy
- Department of Pediatrics, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
| | - Khonsavanh Luangxay
- Department of Pediatrics, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
| | - Kongkham Sisouk
- Department of Pediatrics, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
| | - Bandit Soumphonphakdy
- Department of Pediatrics, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
| | - Khaysy Latsavong
- Department of Pediatrics, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
| | - Kongsin Akkhavong
- Department of Pediatrics, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
| | - Nicholas J. White
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Centre for Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Paul N. Newton
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Centre for Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
- * E-mail:
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Mayxay M, Taylor AM, Khanthavong M, Keola S, Pongvongsa T, Phompida S, Phetsouvanh R, White NJ, Newton PN. Thiamin deficiency and uncomplicated falciparum malaria in Laos. Trop Med Int Health 2007; 12:363-9. [PMID: 17313507 PMCID: PMC7611089 DOI: 10.1111/j.1365-3156.2006.01804.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Thiamin deficiency complicates severe Plasmodium falciparum malaria in Thailand and may contribute to acidosis. We therefore estimated the frequency of biochemical thiamin deficiency in patients presenting with uncomplicated falciparum malaria in southern Laos. METHODS Red cell transketolase activation coefficients (alpha) were measured in 310 patients presenting with uncomplicated falciparum malaria and 42 days after starting treatment. RESULTS Twelve per cent of patients had biochemical evidence of severe deficiency (alpha values >1.31) at presentation, declining to 3% 42 days later. CONCLUSION Thiamin deficiency was common in Lao patients admitted with uncomplicated P. falciparum infection and was reduced following treatment of malaria and multivitamin supplementation. The role of this preventable and treatable disorder in malaria and other acute infections, and the incidence of beriberi in rural Laos, needs further investigation.
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Affiliation(s)
- Mayfong Mayxay
- Wellcome Trust–Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
- Department of Medicine, Faculty of Medical Science, National University of Laos, Lao PDR
| | - Ann M. Taylor
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, UK
| | | | - Siamphay Keola
- Phalanxay District Clinic, Savannakhet Province, Lao PDR
| | | | - Samlane Phompida
- Centre of Malariology, Parasitology and Entomology, Vientiane, Lao PDR
| | | | - Nicholas J. White
- Wellcome Trust–Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, UK
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Paul N. Newton
- Wellcome Trust–Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, UK
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11
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Heap LC, Pratt OE, Ward RJ, Waller S, Thomson AD, Shaw GK, Peters TJ. Individual susceptibility to Wernicke-Korsakoff syndrome and alcoholism-induced cognitive deficit: impaired thiamine utilization found in alcoholics and alcohol abusers. Psychiatr Genet 2002; 12:217-24. [PMID: 12454526 DOI: 10.1097/00041444-200212000-00004] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To investigate mechanisms predisposing to alcoholic brain damage, thiamine (vitamin B1 ), riboflavin (vitamin B2 ) and pyridoxine (vitamin B6 ) status was compared in persistent alcohol misusers (PAM) admitted for detoxification without evidence of significant brain damage, in alcoholics known to have severe chronic brain damage (BDAM), and in age, gender and ethnicity matched controls. Thus, activities of thiamine-dependent transketolase (ETK), riboflavin-dependent glutathione reductase, and pyridoxine-dependent aspartate amino transferase were assayed, together with the enzyme activities following addition of the appropriate co-factor. Twenty per cent of the PAM group had an abnormally low ETK activity and an abnormally high activation ratio, while 45% were abnormal in either one or both parameters. An additional 10% of the PAM group had an abnormally high activation ratio but normal ETK activity, as did 30% of the BDAM group. These subgroups of alcohol misusers may have increased requirements for thiamine secondary to an abnormality of the transketolase protein that may predispose such patients to alcoholic brain damage. There was no evidence of riboflavin or pyridoxine deficiency in either of the patient groups. We conclude that thiamine deficiency was commonly present in the alcoholic patients, and that a subgroup of patients may be predisposed to more severe brain damage as a consequence of abnormalities in the transketolase protein.
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Affiliation(s)
- Laura C Heap
- Department of Clinical Biochemistry, Kings College School of Medicine and Dentistry, London, UK
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12
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Bovet P, Larue D, Fayol V, Paccaud F. Blood thiamin status and determinants in the population of Seychelles (Indian Ocean). J Epidemiol Community Health 1998; 52:237-42. [PMID: 9616410 PMCID: PMC1756702 DOI: 10.1136/jech.52.4.237] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
STUDY OBJECTIVE Micronutrient deficiencies have become rare in industrialised countries as availability of fresh food, supplementation, and fortification have improved but a less favourable situation may still prevail in many developing countries. Blood thiamin status and determinants were therefore investigated in the Seychelles in view of the high incidence of dilated cardiomyopathy and as the staple diet is polished rice that is deficient in thiamin. DESIGN This was a cross sectional population study using an age and sex stratified random sample. SETTING Seychelles Islands (Indian Ocean). PARTICIPANTS A subsample of 206 subjects aged 25-64 years from the population of Seychelles. MAIN OUTCOME MEASURES Measurement of total thiamin concentration in whole blood using high performance liquid chromatography. Dietary variables measured using a face to face semi-quantitative food questionnaire. RESULTS Mean (SD) whole blood thiamin concentration was 77.9 (22.4) nmol/l and low concentration (< 70 nmol/l) was found in 37% of the subjects (95% CI: 31%, 44%). Blood thiamin was significantly related to education and diet but not to age, sex, smoking, and body mass index. Blood thiamin was associated positively with meat, vegetable, salad, and tea intake and negatively with alcohol and fish intake. However, no combination of the examined variables could explain more than 15% of the observed variance in blood thiamin values. CONCLUSIONS These data suggest that the distribution of blood thiamin in the sampled population is shifted to lower values compared with that generally accepted as normal in European populations. Further research should establish the significance of such lower values in this specific population to facilitate clinical and public health action as necessary.
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Affiliation(s)
- P Bovet
- Institute of Social and Preventive Medicine, University of Lausanne, Switzerland
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Turkki PR, Ingerman L, Schroeder LA, Chung RS, Chen M, Russo-Mcgraw MA, Dearlove J. Thiamin and vitamin B6 intakes and erythrocyte transketolase and aminotransferase activities in morbidly obese females before and after gastroplasty. J Am Coll Nutr 1992; 11:272-82. [PMID: 1619179 DOI: 10.1080/07315724.1992.10718228] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
To assess the need for postoperative vitamin supplements, intakes and nutritional status of thiamin (B1) and vitamin B6 were studied in 18 female gastroplasty patients who received a placebo or different levels of supplemental vitamins. Postoperative erythrocyte transketolase basal (BA) and thiamin pyrophosphate-stimulated (SA) activities and activity coefficients (AC) correlated significantly with B1 intake. Despite a decrease in apotransketolase, low thiamin intakes were associated with increased AC values during the first 3 months. With return to low B1 intakes following repletion during month 4, the AC values remained normal with low total activities. Both alanine (EALT) and aspartate (EAST) aminotransferase apoenzyme levels declined and AC values increased significantly during the first 3 months. Although the EALT-indices were more sensitive to changes in B6 intake than the EAST-indices, the EASTBA and SA correlated most consistently with the intake. Postoperative dietary intakes of both vitamins were inadequate for maintenance of normal activities of these erythrocyte enzymes. Although B1 intake of greater than or equal to 1.0 mg/day was adequate for maintenance of normal thiamin status in most subjects of this study, supplementation with greater than or equal to 1.5 mg/day is prudent even though it may not prevent the early postoperative loss of apotransketolase. Vitamin B6 intake at the current recommended dietary allowance (1.6 mg) was not adequate to maintain coenzyme saturation of the erythrocyte aminotransferases. Marginal intake of other nutrients may have affected the utilization of both thiamin and vitamin B6.
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Affiliation(s)
- P R Turkki
- Dept. of Nutrition and Food Management, Syracuse University, NY 13244-1250
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Nixon PF, Price J, Norman-Hicks M, Williams GM, Kerr RA. The relationship between erythrocyte transketolase activity and the 'TPP effect' in Wernicke's encephalopathy and other thiamine deficiency states. Clin Chim Acta 1990; 192:89-98. [PMID: 2073741 DOI: 10.1016/0009-8981(90)90072-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Patients (n = 104) were judged to be thiamine deficient by the criteria of erythrocyte transketolase activity (ETK) less than 0.6 U/g of hemoglobin, or greater than 17% increase in this activity on addition of thiamine pyrophosphate in vitro (TPP effect). ETK activated by TPP in vitro (AETK) was related to ETK by a linear regression of slope greater than or equal to 1, implying that transketolose apoenzyme (apoTK) was constant or decreased as ETK decreased. For most patient groups the value of apoTK was 0.1 U/g and the slope 1.033 to 1.050. In the subgroup of non-vomiting drinkers with Wernicke's encephalopathy (WE), the slope of the linear regression of AETK on ETK was 1.21, so that apoTK decreased as ETK decreased. Comparison of these data is consistent with a difference in the TK of WE drinkers from that of others. Generally, any variation of TPP effect was due only to variation of ETK. We recommend measurement of ETK, without TPP effect, for the assessment of thiamine nutrition.
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Affiliation(s)
- P F Nixon
- Department of Biochemistry, University of Queensland, Brisbane, Australia
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Thomas AJ, Finglas P, Bunker VW. The B vitamin content of hospital meals and potential low intake by elderly inpatients. J Hum Nutr Diet 1988. [DOI: 10.1111/j.1365-277x.1988.tb00201.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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