Vitamin B12 in neurology and ageing; Clinical and genetic aspects

The classic neurological and psychiatric features associated with vitamin B₁₂ deficiency have been well described and are the subject of many excellent review articles. The advent of sensitive diagnostic tests, including homocysteine and methylmalonic acid assays, has revealed a surprisingly high prevalence of a more subtle ‘subclinical’ form of B₁₂ deficiency, particularly within the elderly. This is often associated with cognitive impairment and dementia, including Alzheimer's disease. Metabolic evidence of B₁₂ deficiency is also reported in association with other neurodegenerative disorders including vascular dementia, Parkinson's disease and multiple sclerosis. These conditions are all associated with chronic neuro-inflammation and oxidative stress. It is possible that these clinical associations reflect compromised vitamin B₁₂ metabolism due to such stress. Physicians are also increasingly aware of considerable inter-individual variation in the clinical response to B₁₂ replacement therapy. Further research is needed to determine to what extent this is attributable to genetic determinants of vitamin B₁₂ absorption, distribution and cellular uptake.     

Vitamin B12 regulates photosystem gene expression via the CrtJ antirepressor AerR in Rhodobacter capsulatus

The tetrapyrroles haem, bacteriochlorophyll and cobalamin (B₁₂) exhibit a complex interrelationship regarding their synthesis. In this study, we demonstrate that AerR functions as an antirepressor of the tetrapyrrole regulator CrtJ. We show that purified AerR contains B₁₂ that is bound to a conserved histidine (His145) in AerR. The interaction of AerR to CrtJ was further demonstrated in vitro by pull down experiments using AerR as bait and quantified using microscale thermophoresis. DNase I DNA footprint assays show that AerR containing B₁₂ inhibits CrtJ binding to the bchC promoter. We further show that bchC expression is greatly repressed in a B₁₂ auxotroph of Rhodobacter capsulatus and that B₁₂ regulation of gene expression is mediated by AerR's ability to function as an antirepressor of CrtJ. This study thus provides a mechanism for how the essential tetrapyrrole, cobalamin controls the synthesis of bacteriochlorophyll, an essential component of the photosystem.     

Vitamin B12, a chlorophyll-related analog to pheophytin a from marine brown algae, promotes neurite outgrowth and stimulates differentiation in PC12 cells

We previously isolated an analog to chlorophyll-related compounds, pheophytin a, from the marine brown alga Sargassum fulvellum and demonstrated that it is a neurodifferentiation compound. In the current study, we investigated the effects of the pheophytin a analog vitamin B₁₂ on PC12 cell differentiation. In the presence of a low level of nerve growth factor (10 ng ml⁻¹), vitamin B₁₂ demonstrated neurite outgrowth-promoting activity in PC12 cells. The effect was dose-dependent in the range of 6–100 μM. In the absence of nerve growth factor, vitamin B₁₂ did not promote differentiation. To investigate the mechanism for this effect, we conducted differentiation assays and western blot analysis with signal transduction inhibitors and found that vitamin B₁₂ did not promote PC12 cell differentiation in the presence of K252a or U0126 inhibitors. These results suggest that vitamin B₁₂ stimulates PC12 cell differentiation through enhancement of the mitogen-activated protein kinase signal transduction pathway, which is also induced by nerve growth factor. Thus, vitamin B₁₂ may be a good candidate for treatment of neurodegenerative diseases such as Alzheimer’s disease.     

Vitamin-B12 Status of Patients on Long-term Metformin Therapy

Vitamin-B₁₂ malabsorption has been found in 21 (30%) of 71 diabetic patients taking long-term metformin therapy in addition to dietary management. The patients with evidence of B₁₂ malabsorption had significantly lower haemoglobin levels (and significantly higher serum folic acid levels) than those with normal B₁₂ absorption. Steatorrhoea was found in only one patient. Stopping metformin therapy resulted in reversion of B₁₂ absorption to normal in most patients examined. Four patients with B₁₂ malabsorption were found to have pathologically low serum B₁₂ levels. The causes and implications of these findings are discussed and it is concluded that all patients on long-term metformin therapy should have annual serum B₁₂ estimations.     

Effects of maternal vitamin B12 deficiency from end of gestation to weaning on the growth and haematological and immunological parameters in mouse dams and offspring

Vitamin B₁₂-deficiency may induce specific symptoms as neurological alterations and unspecific symptoms such as anaemia and growth retardation. In this study, maternal vitamin B₁₂ deficiency from end of gestation to weaning was evaluated in mouse dams, which was provoked by feeding a vitamin B₁₂-deficient diet. The animals were divided into two groups (control and deficient). The control group received the vitamin B₁₂-deficient diet supplemented with commercial vitamin B₁₂. Compared to the control, the vitamin B₁₂-deficient dams and their offspring showed a significant decrease of body weight (by 20 and 39%, respectively), serum vitamin B₁₂ concentration (by 61 and 67%, respectively), haematological values as haematocrit (25 and 26%, respectively), and IgA producer cells (by 36 and 54%, respectively). In both, vitamin B₁₂-deficient mouse dams and their offspring, histological alterations of small intestine were observed, whereas growth retardation occurred in the offspring only. This experimental murine model allows assessing the incidence of maternal cobalamin deficiency in offspring and would be useful for evaluating novel adjuncts such as functional foods to prevent vitamin B₁₂ deficiency.     

Exploring the onset of B12-based mutualisms using a recently evolved Chlamydomonas auxotroph and B12-producing bacteria

Cobalamin (vitamin B₁₂) is a cofactor for essential metabolic reactions in multiple eukaryotic taxa, including major primary producers such as algae, and yet only prokaryotes can produce it. Many bacteria can colonize the algal phycosphere, forming stable communities that gain preferential access to photosynthate and in return provide compounds such as B₁₂. Extended coexistence can then drive gene loss, leading to greater algal–bacterial interdependence. In this study, we investigate how a recently evolved B₁₂-dependent strain of Chlamydomonas reinhardtii, metE7, forms a mutualism with certain bacteria, including the rhizobium Mesorhizobium loti and even a strain of the gut bacterium E. coli engineered to produce cobalamin. Although metE7 was supported by B₁₂ producers, its growth in co-culture was slower than the B₁₂-independent wild-type, suggesting that high bacterial B₁₂ provision may be necessary to favour B₁₂ auxotrophs and their evolution. Moreover, we found that an E. coli strain that releases more B₁₂ makes a better mutualistic partner, and although this trait may be more costly in isolation, greater B₁₂ release provided an advantage in co-cultures. We hypothesize that, given the right conditions, bacteria that release more B₁₂ may be selected for, particularly if they form close interactions with B₁₂-dependent algae.     

Vitamin B12-dependent methionine synthesis in Rhizobium meliloti

Methionine, among the various additions to the medium, could only replace cobalt ion or vitamin B₁₂ required for the growth of $\text{Rhizobium meliloti}$. It was demonstrated that there exists a vitamin B₁₂-dependent terminal step in the methionine synthesis, that is, N⁵CH₃-tetrahydrofolate-homocysteine transmethylase, which can also catalyze the methyl transfer from CH₃B₁₂ to homocysteine, in the cell-free extracts of Rhizobium meliloti. These facts seem to indicate that the vitamin B₁₂-dependent pathway to methionine functions mainly among the B₁₂-dependent enzymatic systems in the wild-type symbionts and this is the chief nutritional significance of cobalt.     

Functional redundancy of seasonal vitamin B12 biosynthesis pathways in coastal marine microbial communities

Vitamin B₁₂ (cobalamin) is a major cofactor required by most marine microbes, but only produced by a few prokaryotes in the ocean, which is globally B₁₂-depleted. Despite the ecological importance of B₁₂, the seasonality of B₁₂ metabolisms and the organisms involved in its synthesis in the ocean remain poorly known. Here we use metagenomics to assess the monthly dynamics of B₁₂-related pathways and the functional diversity of associated microbial communities in the coastal NW Mediterranean Sea over 7 years. We show that genes related to potential B₁₂ metabolisms were characterized by an annual succession of different organisms carrying distinct production pathways. During the most productive winter months, archaea (Nitrosopumilus and Nitrosopelagicus) were the main contributors to B₁₂ synthesis potential through the anaerobic pathway (cbi genes). In turn, Alphaproteobacteria (HIMB11, UBA8309, Puniceispirillum) contributed to B₁₂ synthesis potential in spring and summer through the aerobic pathway (cob genes). Cyanobacteria could produce pseudo-cobalamin from spring to autumn. Finally, we show that during years with environmental perturbations, the organisms usually carrying B₁₂ synthesis genes were replaced by others having the same gene, thus maintaining the potential for B₁₂ production. Such ecological insurance could contribute to the long-term functional resilience of marine microbial communities exposed to contrasting inter-annual environmental conditions.     

Vitamin B12 Content of Circulating Leukocytes as an Aid in the Differentiation of the Acute Leukemias

From 25 patients with acute leukemia 116 specimens of leukocytes were assayed microbiologically for total vitamin B₁₂ to determine if variation in vitamin B₁₂ content would help in differentiating the acute leukemias. The mean cell vitamin B₁₂ levels (μμg./10⁸ cells) in the different types of leukemia were: lymphoblastic 464, myeloblastic 1058 and monocytic 200. Cell vitamin B₁₂ levels above the normal range (100-800 μμg./10⁸ cells) are suggestive of myeloblastic leukemia. The only elevated cell vitamin B₁₂ levels comparable to those found in myeloblastic leukemia were in reticulum cell leukemia, and this type of leukemia was not difficult to diagnose morphologically. Blast cells contained more vitamin B₁₂ than mature cells of the same series; there was a significant positive correlation between the percentage of blast cells and cell levels of total vitamin B₁₂ in both lymphoblastic and myeloblastic leukemia.     

THE EFFECT OF VITAMIN B12 ON THE ANEMIA AND COMBINED SYSTEM DISEASE OF ADDISONIAN PERNICIOUS ANEMIA

The effect of the parenteral administration of vitamin B₁₂ has been observed in eight patients with Addisonian pernicious anemia.Vitamin B₁₂ in initial doses of 50 micrograms or 25 micrograms induced satisfactory reticulocyte response and a return of erythrocyte count to within normal range in 60 days.In only two of the patients were secondary reticulocyte responses induced on a second injection of vitamin B₁₂.Concurrently with the hemopoietic response, the bone marrow changed from megaloblastic hyperplasia to normoblastic distribution.The paresthesias associated with combined system disease as well as disturbances in position sense and locomotor function may be entirely relieved or greatly diminished following injections of vitamin B₁₂.Maintenance injections of vitamin B₁₂ may be from 30 to 50 micrograms at intervals of one month, the amount depending upon the individual case.Vitamin B₁₂ may be used without untoward symptoms in patients previously sensitive to liver extract.     

Effects of Carnosine and Anserine on the Destruction of Vitamin B12 with Vitamin C in the Presence of Copper

Vitamin B₁₂ is destroyed by the addition of substantial amounts of vitamin C in the presence of copper. Effects of carnosine and anserine, natural water-soluble antioxidants, on the destruction of vitamin B₁₂, were studied. Addition of carnosine (l0mM) effectively repressed the destruction of vitamin B₁₂, but anserine had only weak inhibitory effects.     

Nutrition-Related Vitamin B12 Deficiency in Patients in Pakistan with Type 2 Diabetes Mellitus not Taking Metformin

ObjectiveTo estimate the frequency of undiagnosed vitamin B₁₂ deficiency among patients with type 2 diabetes mellitus who had not taken metformin during at least the prior 5 years and to ascertain whether vitamin B₁₂ deficiency among the patients with type 2 diabetes was due to nutritional deficiency or malabsorption.MethodsSerum vitamin B₁₂ levels were measured in 44 subjects with diabetes and a mean age of 51 years (range, 40 to 70), 21 (48%) of whom had low levels (< 200 pg/mL). Of those 21 patients, 10 agreed to enroll in an intervention phase consisting of oral supplementation with mecobalamin, 1,500 μg daily for 3 months. Those patients in whom vitamin B₁₂ levels failed to normalize after oral supplementation alone would be presumed to have vitamin B₁₂ deficiency attributable to malabsorption.ResultsAlmost half of the subjects with type 2 diabetes not taking metformin had biochemically proven vitamin B₁₂ deficiency. All 10 subjects who enrolled in the intervention phase had normalization of their vitamin B₁₂ levels after 3 months of oral supplementation with mecobalamin.ConclusionWe conclude that vitamin B₁₂ deficiency is common among patients with type 2 diabetes and was related to nutrition in our study group. In addition to intensive glycemic control, vitamin B₁₂ supplementation should be considered for treatment of diabetic neuropathy. In almost 50% of patients with low vitamin B₁₂ levels, the deficiency was corrected with oral supplementation only. This, indeed, is an important finding, inasmuch as oralvitamin B₁₂ supplementation is easy, convenient, and readily accepted by patients. This finding highlights the need for aggressive and early diagnosis and treatment to avoid complications of vitamin B₁₂ deficiency. (Endocr Pract. 2010;16:205-208)     

VITAMIN B12-BINDER AND OTHER ALGAL INHIBITORS1

Euglena gracilis Klebs, Poterioochromonas malhamensis (Pringsheim) Peterfi, Monochrysis lutheri Droop, Isochrysis galbana Parke and Phaeodactylum tricornutum Bohlin are known to release into the medium a substance which binds free vitamin B₁₂. The binder, apparently a glycoprotein, makes vitamin B₁₂ unavailable and inhibits growth of vitamin B₁₂-requiring microorganisms. Culture filtrates of selected marine diatoms, chrysophytes, cryptophytes, dinoflagellates and green algae contained the binder, indicating that binder release was not restricted to any algal group. However the three prokaryotic bluegreens tested do not produce B₁₂-binder. Production is also independent of the nutritional requirements of the donor, being produced by autotrophs and auxotrophs. The binders produced by these marine species have similar properties: they are heat labile; inhibition is not species-specific; it is competitive, being reversed by adding B₁₂. Production increases with density of the culture and is not restricted to stationary or scenescent cells. The marine species tested produced much less B₁₂ than the freshwater Euglena and Poterioochromonas; the inhibition is reversed by 20–50 ng · 1^?1 of B₁₂ for marine species which reach moderate densities and by 150–300 ng · 1^?1 B₁₂ for the densely growing species. Consequently the binder may affect the growth of B₁₂-requiring species only in environments like the open ocean poor in B₁₂. By contrast, the marine algae produce other inhibitors which are often heat stable and very inhibitory. These inhibitors, being species-specific and less labile, may be more important in affecting the succession of algal species in natural waters.     

One pathway can incorporate either adenine or dimethylbenzimidazole as an alpha-axial ligand of B12 cofactors in Salmonella enterica

Corrinoid (vitamin B₁₂-like) cofactors contain various α-axial ligands, including 5,6-dimethylbenzimidazole (DMB) or adenine. The bacterium Salmonella enterica produces the corrin ring only under anaerobic conditions, but it can form “complete” corrinoids aerobically by importing an “incomplete” corrinoid, such as cobinamide (Cbi), and adding appropriate α- and β-axial ligands. Under aerobic conditions, S. enterica performs the corrinoid-dependent degradation of ethanolamine if given vitamin B₁₂, but it can make B₁₂ from exogenous Cbi only if DMB is also provided. Mutants isolated for their ability to degrade ethanolamine without added DMB converted Cbi to pseudo-B₁₂ cofactors (having adenine as an α-axial ligand). The mutations cause an increase in the level of free adenine and install adenine (instead of DMB) as an α-ligand. When DMB is provided to these mutants, synthesis of pseudo-B₁₂ cofactors ceases and B₁₂ cofactors are produced, suggesting that DMB regulates production or incorporation of free adenine as an α-ligand. Wild-type cells make pseudo-B₁₂ cofactors during aerobic growth on propanediol plus Cbi and can use pseudo-vitamin B₁₂ for all of their corrinoid-dependent enzymes. Synthesis of coenzyme pseudo-B₁₂ cofactors requires the same enzymes (CobT, CobU, CobS, and CobC) that install DMB in the formation of coenzyme B₁₂. Models are described for the mechanism and control of α-axial ligand installation.     

Low holo-transcobalamin levels are prevalent in vegetarians and is associated with coronary artery disease in Indian population

Coronary artery disease (CAD) has been increasing alarmingly in India. We had earlier shown that vitamin B₁₂ deficiency is associated with CAD in Indian population. However, only about a quarter of the total vitamin B₁₂ is internalised in the cells by the proteins transcobalamin II. Vitamin B₁₂-bound transcobalamin II (holotranscobalamin, holoTC) is thus referred to as biologically active B₁₂. In this study, we ascertained the levels of holoTC in 501 CAD cases and 1253 healthy controls and for the first time show that holoTC levels are significantly lower (p?=?2.57E-4) in CAD (26.81?pmol/l) cases as compared to controls (29.97?pmol/l).     

Vitamin B12 Excretion in Patients with Various Skin Diseases

The excretion in the urine of ⁵⁸Co after an oral dose of ⁵⁸Co vitamin B₁₂ given together with intrinsic factor has been found to be reduced in a number of patients with psoriasis, eczema, and other less common dermatoses. There is a correlation between the abnormality and the extent of the rash. A reduced glomerular filtration rate was found in a few of the patients in whom it was measured, and this must have been responsible, at least in part, for the reduced excretion of vitamin B₁₂ in these patients, but abnormal vitamin B₁₂ excretion also occurred in the absence of impaired renal function. Our evidence is insufficient to show whether malabsorption or increased tissue utilization of vitamin B₁₂ was the explanation in other cases. Certainly a number of patients had steatorrhoea, and in these it is most likely that malabsorption was the major factor. In patients without steatorrhoea a lone malabsorption of vitamin B₁₂ cannot be excluded. A decreased serum concentration of vitamin B₁₂ was found in only one of the patients.     

Myelin lipids in vitamin B12 deficiency in chicks

Lipid profile of the spinal cord myelin was studied in normal and vitamin B₁₂ deficient chicks. The significant findings were a reduction in the total galactolipids and an increase in the total phospholipids of myelin in vitamin B₁₂ deficiency. The altered molar ratios of these lipids suggest a relative immaturity of the myelin in this condition. These changes may initiate the degenerative changes in the central nervous system in vitamin B₁₂ deficiency.Vitamin B₁₂ is essential for normal functioning of both the hemopoietic and the nervous system. Sub-acute combined degeneration of the spinal cord is seen both in association with pernicious anemia and in megaloblastic anemia of dietary origin (1,2). Though many biochemical postulates (3, 4) have been advanced to explain the neurological changes, the role of vitamin B₁₂ in maintaining the integrity of myelin is still obscure. So far only in two animal species the monkey (5) and the chick (6) has myelin degeneration been reported in vitamin B₁₂ deficiency. However, in neither of these reports, have changes in the composition of myelin been described. The results of a study in chicks wherein the effects of vitamin B₁₂ on the lipid profile of myelin were investigated are reported here.     

Vitamin B<Subscript>12</Subscript> as a carrier for targeted platinum delivery: in vitro cytotoxicity and mechanistic studies

It is attractive to use vitamin B₁₂ as a carrier for targeted delivery of cytotoxic agents such as platinum complexes owing to the high demand for vitamin B₁₂ by fast proliferating cells. The basic {B₁₂–CN–Pt^II} conjugates are recognized by intracellular enzymes and converted to coenzyme B₁₂ in an enzymatic adenosylation assay. The reductive adenosylation of {B₁₂–CN–Pt^II} conjugates leads to the release of the Pt^II complexes; thus, {B₁₂–CN–Pt^II} conjugates can be considered as prodrugs. It is important not only to elucidate the activity of the cisplatin–B₁₂ conjugates, but also to understand the mode of action on a molecular level. Chemical reduction of {B₁₂–CN–Pt^II} conjugates with cobaltocene yielded cob(II)alamin and induced release of the corresponding Pt^II species. Kurnakov tests and coordination of 2′-deoxyguanosine or GMP to the released Pt^II complexes allowed isolation and characterization of Pt^II complexes as released during enzymatic adenosylation. The biological activity of these Pt^II complexes was evaluated. Since the cleaved Pt^II complexes show cytotoxicity, the {B₁₂–CN–Pt^II} conjugates can be used for specific targeting of cancer cells and therapeutic drug delivery. Preliminary in vitro cytotoxicity studies indicated lower activity (IC₅₀ between 8 and 88 μM) than found for pure cisplatin. Since active transport and receptor-mediated uptake limits the intracellular {B₁₂–CN–Pt^II} concentration, comparison with pure cisplatin is of limited use. We could show that the Pt^II complexes cleaved from B₁₂ exerted a cytotoxicity comparable to that of cisplatin itself. Cytotoxicity studies in vitamin B₁₂ free media showed a dependence on the addition of transcobalamin II for B₁₂–Pt(II) conjugates.     

Holotranscobalamins in B12 and non B12 requiring prokaryotes and eukaryotes

Transcobalamins, vitamin B₁₂ binding proteins, deliver B₁₂ to cell surface receptors which then permit B₁₂ to cross cell membranes for metabolic use. There is little documentation concerning B₁₂ binding proteins in bacteria and protists. We found that prokaryotes and eukaryotes requiring B₁₂, as well as those protists synthesizing B₁₂, also produce several transcobalamins for functionally transporting B₁₂ similar to humans.