vitamin-k-semiquinone-radical and Fever

Numerous factors affect the response to vitamin K antagonists (VKA) including age, dietary vitamin K, other drugs, pharmacogenetics, and disease states. In antithrombotic guidelines, fever is mentioned as a factor that may increase response to VKA. The purpose of this article is to review the available evidence regarding the effect of fever on response to VKA, and to discuss possible mechanisms of this effect. We performed a search of the English literature from 1943 to June 2014, using the key words fever AND warfarin, acenocoumarol, phenprocoumon, coumarin anticoagulants and VKA; fever AND vitamin K dependent clotting factors II, VII, IX, and X. One animal investigation and 6 studies in humans suggest fever increases response to VKA, but one study did not find a significant effect. The magnitude of this effect is variable. Possible mechanisms for the increased effect of VKA associated with fever are increased catabolism of vitamin K dependent clotting factors, decreased vitamin K intake, and inhibition of VKA metabolism. More rigorous studies are needed to confirm that fever increases response to warfarin and other VKA.

Topics: Acenocoumarol; Animals; Anticoagulants; Clinical Trials as Topic; Coumarins; Fever; Hemorrhage; Humans; International Normalized Ratio; Phenprocoumon; Rats; Risk Factors; Treatment Outcome; Vitamin K; Warfarin

Topics: Ascorbic Acid; Child, Preschool; Deficiency Diseases; Female; Fever; Folic Acid; Humans; Infant; Infant Food; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infections; Kinetics; Male; Milk, Human; Nutritional Physiological Phenomena; Nutritional Requirements; Pyridoxine; Thiamine; Vitamin A; Vitamin A Deficiency; Vitamin D; Vitamin E; Vitamin K; Vitamins

Topics: Bacterial Vaccines; Bicarbonates; Brain Edema; Diagnosis, Differential; Diazepam; Digoxin; Fever; Gastrointestinal Hemorrhage; Heparin; Humans; Hydrocortisone; Infant; Infant, Newborn; Isoproterenol; Mannitol; Meningitis; Meningitis, Meningococcal; Meningitis, Viral; Phenytoin; Seizures; Shock, Septic; Vitamin K

In 34 cancer patients with 40 neutropenic febrile episodes requiring broad-spectrum antimicrobial therapy, detailed dietary assessments revealed that deficient and severely deficient phylloquinone intakes (less than or equal to 70 and less than or equal to 25 micrograms/d) were identified during 88% and 38% of all days recorded, respectively. Serum phylloquinone levels and serial prothrombin times (PT) drawn in a similar group of 32 patients revealed that an elevated PT (greater than or equal to 2 s beyond control) was significantly associated (p less than 0.01) with a serum phylloquinone level of less than 4.4 nmol/L. Patients on antimicrobial regimens that suppressed menaquinone-producing intestinal microflora and that contained an N-methylthiotetrazole (NMTT) moiety had an elevated PT significantly more often than did patients receiving antimicrobial agents that preserved the microflora and contained no NMTT moiety (3 of 10 vs 10 of 11, respectively; p = 0.02 Fisher's exact). These data suggest that these patients have a profound deficiency of oral vitamin K intake that may be further augmented by antimicrobial therapy.

Topics: Agranulocytosis; Anti-Bacterial Agents; Diet; Fever; Humans; Hypoprothrombinemias; Intestines; Neoplasms; Neutropenia; Prothrombin Time; Vitamin K; Vitamin K 1; Vitamin K Deficiency

The intracellular NAD level plays a pivotal role in numerous biological processes such as rhythm, senescence, cancer and death. The study of the intracellular NAD level has been one of the "hotspots" in biomedical research. We investigated the effect of Vitamin K on intracellular NAD level in yeast by fluorescence spectrum in this paper. Plasma membrane redox system of yeast was found to be greatly promoted by the addition of Vitamin K(3) or Vitamin K(1). Ferricyanide reduction catalyzed by Vitamin K was accompanied by the decrease in intracellular NADH concentration and the increase in intracellular NAD level of yeast cells.

Topics: Cell Survival; Fever; NAD; Saccharomyces cerevisiae; Spectrometry, Fluorescence; Vitamin K

Coumarin anticoagulants impair the biological activity of the vitamin K-dependent procoagulant and anticoagulant proteins. There are no reports that focus on the levels of these proteins in over-anticoagulated patients. Therefore, we determined the levels of factor II, factor VII, factor IX and factor X, protein C and protein S in 25 randomly selected over-anticoagulated patients (International Normalized Ratio >/= 6.0) and in 25 matched, therapeutically anticoagulated patients with an International Normalized Ratio within the therapeutic zone. Furthermore, to study a possible effect of the cause of over-anticoagulation, coagulant levels were compared between 16 over-anticoagulated patients with fever in the preceding 2 weeks and 24 over-anticoagulated patients with stable congestive heart failure. The pattern of procoagulant level reductions in the three groups of over-anticoagulated patients was largely the same as in therapeutically anticoagulated patients: factor X was the lowest and factor IX the highest. The difference was that, in over-anticoagulated patients, factor VII was relatively low among the procoagulant factors compared with therapeutically anticoagulated patients. Protein C was lower than protein S in over-anticoagulated patients with congestive heart failure, but was similar to protein S in the other study groups. In over-anticoagulated patients with fever, the vitamin K-dependent coagulation proteins except factor X were significantly lower than in over-anticoagulated patients with congestive heart failure, especially factor VII and protein S.

Topics: Adult; Aged; Aged, 80 and over; Anticoagulants; Blood Coagulation Factor Inhibitors; Blood Coagulation Factors; Case-Control Studies; Coumarins; Drug Overdose; Female; Fever; Heart Failure; Humans; International Normalized Ratio; Male; Middle Aged; Prospective Studies; Vitamin K

Topics: Adrenal Cortex Hormones; Apnea; Biopsy, Needle; Blood Transfusion; Brain Diseases; Electroencephalography; Fatty Liver; Fever; Hepatic Encephalopathy; Humans; Infant; Liver; Male; Neomycin; Peritoneal Dialysis; Reye Syndrome; Unconsciousness; Vitamin K; Vomiting

Topics: Anemia; Angiography; Animals; Cats; Cerebral Hemorrhage; Dogs; Ecchymosis; Embolism; Fever; Gastrointestinal Hemorrhage; Hematoma; Hematuria; Hemorrhage; Hemothorax; Heparin; Humans; Hypotension; Ischemia; Leukocytosis; Shivering; Streptokinase; Thrombosis; Vitamin K

Topics: Animals; Blood Glucose; Body Temperature; Diethylstilbestrol; Ethanol; Fever; Hot Temperature; Male; Methylene Blue; Rats; Sarcoma, Experimental; Sarcoma, Yoshida; Vitamin K

Topics: Animals; Body Temperature; Carcinoma, Ehrlich Tumor; Diethylstilbestrol; Fever; Glucose; Hot Temperature; Hydrogen-Ion Concentration; Mice; Oxygen; Partial Pressure; Vitamin K

Topics: Animals; Ascites; Body Temperature Regulation; Carcinoma, Ehrlich Tumor; Depression, Chemical; Diethylstilbestrol; Dimethyl Sulfoxide; Ethanol; Fever; Glucose; Mice; Rabbits; Stimulation, Chemical; Surface-Active Agents; Vitamin K

Topics: Animals; Carcinoma, Ehrlich Tumor; Dogs; Fatty Liver; Female; Fever; Hemorrhage; Male; Methylene Blue; Mice; Necrosis; Nephrosis; Rats; Sodium; Species Specificity; Sulfites; Vitamin K

Topics: Animals; Diethylstilbestrol; Fatty Acids, Essential; Fever; In Vitro Techniques; Male; Methylene Blue; Quinacrine; Rats; Sarcoma, Experimental; Sarcoma, Yoshida; Sodium; Sulfites; Vitamin B Complex; Vitamin K

Topics: Animals; Carcinogens; Carcinoma, Ehrlich Tumor; Fever; Methylene Blue; Mice; Neoplasms; Trypan Blue; Vitamin K