vitamin-b-12 and Diphyllobothriasis

Recent developments in our knowledge of the biochemistry and metabolism of cobalamin have given us some insight into clinical disorders. N2O, which easily induces cobalamin deficiency, both in vivo and in vitro, has greatly contributed to the investigation of the cobalamin deficient state, especially in relation to folate and amino acid metabolism. Demonstration of the cobalamin analog in human serum and a new enzyme which requires cobalamin as a coenzyme has led to recent increased interest in this field. The disorders of cobalamin metabolism will be summarized briefly as well as those areas currently of particular interest.

Topics: 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase; Amino Acid Isomerases; Anemia, Pernicious; Animals; Diphyllobothriasis; DNA; Folic Acid; Humans; Intestinal Absorption; Intestinal Mucosa; Intramolecular Transferases; Malabsorption Syndromes; Methylmalonyl-CoA Mutase; Methyltransferases; Nervous System Diseases; Nitrous Oxide; Pancreatic Diseases; Thymidine Monophosphate; Vitamin B 12; Zollinger-Ellison Syndrome

This review focusses on research performed by the author and coworkers. The absorption, turnover and excretion of cobalamin and the pathogenesis of cobalamin deficiency states are described and the laboratory tests used to diagnose these states are discussed. Topics dealt with in detail include: overall turnover, daily need, enterohepatic circulation and excretion of cobalamin and other corrins . The soluble proteins mediating cobalamin transport and their cellular receptors are described and their nomenclature, isolation, structure and mode of action, the role of calcium in the membrane transport, the evolution of these systems and the analogies with transport systems for other substrates are discussed together with deficiency states, especially fish tapeworm anemia and familial selective vitamin B12 malabsorption with proteinuria. Folate deficiency is a relatively rare cause of megaloblastic anemia in Scandinavia but common in North America and explanations for this difference are suggested. The methods of assaying cobalamin in serum and plasma and the performance of radiovitamin B12 absorption tests are critically evaluated. The measurement of intrinsic factor in gastric juice, serum, amniotic fluid and urine is described.

Topics: Anemia, Megaloblastic; Anemia, Pernicious; Biological Transport; Corrinoids; Diet; Diphyllobothriasis; Endocytosis; Erythrocyte Indices; Folic Acid; Humans; Intestinal Absorption; Intrinsic Factor; Malabsorption Syndromes; Membrane Transport Proteins; Metabolic Clearance Rate; Receptors, Cell Surface; Receptors, Peptide; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

In summary, it appears that giardiasis, coccidiosis, cryptosporidiosis, strongyloidiasis, capillariasis and perhaps P. falciparum malaria are the only parasitic diseases which cause malabsorption of many nutrients. D. latum and A. lumbricoides interfere with vitamin B12 and vitamin A absorption, respectively. In view of the increasing use of immunosuppressive therapy, it is likely that malabsorption caused by intestinal parasites may become even more evident in the future.

Topics: Ancylostomiasis; Apicomplexa; Ascariasis; Capillaria; Coccidiosis; Diphyllobothriasis; Giardiasis; Humans; Intestinal Diseases, Parasitic; Malabsorption Syndromes; Malaria; Nematode Infections; Plasmodium falciparum; Protozoan Infections; Schistosomiasis; Strongyloidiasis; Vitamin A; Vitamin B 12

Topics: Absorption; Aged; Anemia, Pernicious; Animals; Biological Transport; Chemical Phenomena; Chemistry; Child; Diphyllobothriasis; Food Analysis; Humans; Intestinal Absorption; Intrinsic Factor; Malabsorption Syndromes; Nutritional Requirements; Stomach; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency; Zollinger-Ellison Syndrome

Twenty cases of Dyphillobothrium pacificum (fish tapeworm) infections were prospectively studied to determine whether this tapeworm is associated with megaloblastic anemia, as commonly reported for D. latum infections. The most frequent symptoms were fatigue and mild abdominal pain, which were identified in approximately 66.6% of the 18 patients interviewed. Fourteen patients received treatment with niclosamide and all were cured. The other six patients spontaneously eliminated the tapeworms. One patient, who also had chronic diabetes and gastric atrophy, had low vitamin B12 levels and megaloblastic anemia. In all other patients, including three other patients with anemia, baseline vitamin B12 levels were in the reference range and did not significantly change when re-assessed three months later. Unlike D. latum, infection with D. pacificum is seldom associated with megaloblastic anemia or vitamin B12 deficit.

Topics: Adolescent; Adult; Aged; Anemia, Megaloblastic; Child; Child, Preschool; Diphyllobothriasis; Female; Humans; Male; Middle Aged; Vitamin B 12; Young Adult

The distribution of labeled cyanocobalamin (CN-[57Co]Cbl = [57Co]-vitamin B12) in pleurocercoids and adult tapeworms of Spirometra mansonoides was studied during development in mice 22 days days PI, respectively. Plerocercoid scolices, obtained by cutting away their bodies or by in vitro enzymatic dissolution of the bodies, were pulsed with CN- magnitude of 57Co Cbl for 1h at 37 degrees C and reimplanted subcutaneously into mice or given per os to cats. In regenerated plerocercoids, the highest concentration of magnitude of 57Co Cbl occurred in the scolex and then decreased posteriorly in the newly-formed tissues of the body. Approximately 60% of the total magnitude of 57Co Cbl present remained concentrated in the scolex following body regeneration plerocercoids and adult tapeworms of Spirometra mansonoides was studied during development in mice 22 days post-infection (PI) and in cats 16 days PI, respectively. Plerocercoid scolices, obtained by cutting away their bodies or by in vitro enzymatic dissolution of the bodies, were pulsed with CN-[57Co]Cbl for 1 h at 37 degrees C and reimplanted subcutaneously into mice or given per os to cats. In regenerated plerocercoids, the highest concentration of [57Co]Cbl occurred in the scolex and then decreased posteriorly in the newly-formed tissues of the body. Approximately 60% of the total [57Co]Cbl present remained concentrated in the scolex following body regeneration for up to 109 days PI. This high [57Co]Cbl concentration in the plerocercoid scolex was bound to protein and appears to be maintained by a complex homeostatic mechanism in association with directional transport of [57Co]Cbl to the scolex with ultimate depletion along the length of the body.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Cat Diseases; Cats; Cestoda; Diphyllobothriasis; Female; Intestine, Small; Male; Mice; Mice, Inbred ICR; Spirometra; Vitamin B 12

Topics: Adolescent; Anemia, Macrocytic; Anemia, Megaloblastic; Diphyllobothriasis; Feeding Behavior; Humans; Intestinal Diseases, Parasitic; Male; Niclosamide; Vitamin B 12

Topics: Adult; Animals; Cobalt Radioisotopes; Diphyllobothriasis; Diphyllobothrium; Female; Gastric Juice; Humans; Kinetics; Male; Middle Aged; Schilling Test; Vitamin B 12

A mixture of vitamin B12 and normal gastric juice, instilled through an intestinal tube into the ileum, produces haematological remission in patients with tapeworm pernicious anaemia. When a similar mixture is administered by mouth, this effect fails to occur. This observation constitutes evidence in favour of the view that Diphyllobothrium latum, attached to the proximal portion (jejunum) of the intestine, absorbs the vitamin B12 contained in the food, thus preventing vitamin bound to the intrinsic factor of the gastric juice from reaching the receptors in the distal portions of the small intestine of the host. In genuine pernicious anaemia, remission results from the administration of vitamin B12+gastric juice both by mouth and into the ileum.

Topics: Adult; Aged; Anemia, Pernicious; Diphyllobothriasis; Female; Gastric Juice; Humans; Ileum; Intubation, Gastrointestinal; Male; Middle Aged; Vitamin B 12

Topics: Anemia, Macrocytic; Anemia, Megaloblastic; Diet; Diphyllobothriasis; Diphyllobothrium; Finland; Humans; Vitamin B 12

Topics: Adult; Anemia, Macrocytic; Anemia, Pernicious; Autoantibodies; Blood Cell Count; Diagnosis, Differential; Diphyllobothriasis; Female; Humans; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Schilling Test; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Bone Marrow Examination; Cobalt Isotopes; Diphyllobothriasis; Erythrocyte Count; Folic Acid; Hematocrit; Humans; Injections, Intravenous; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Animals; Cestode Infections; Diphyllobothriasis; Diphyllobothrium; Epidemiology; Finland; Fishes; Humans; Vitamin B 12

Topics: Animals; Anthelmintics; Biological Assay; Blood Chemical Analysis; Cestode Infections; Diphyllobothriasis; Diphyllobothrium; Erythrocyte Count; Hemoglobinometry; Humans; Metabolism; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Absorption; Achlorhydria; Animals; Cestode Infections; Diphyllobothriasis; Diphyllobothrium; Gastric Acidity Determination; Humans; Vitamin B 12

Topics: Animals; Corrinoids; Diphyllobothriasis; Diphyllobothrium; Hematinics; Infections; Statistical Distributions; Vitamin B 12

Topics: Anemia; Animals; Cestode Infections; Diphyllobothriasis; Diphyllobothrium; Folic Acid; Humans; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Animals; Ascaris; Cestoda; Corrinoids; Diphyllobothriasis; Diphyllobothrium; Humans; Vitamin B 12