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Association of homocysteine (but not of MTHFR 677 C>T, MTR 2756 A>G, MTRR 66 A>G and TCN2 776 C>G) with ischaemic cerebrovascular disease in Sicily.

Association between methylenetetrahydrofolate reductase polymorphism (MTHFR 677 C>T ), a determinant of homocysteine plasma level (t-Hcys), with ischaemc cerebrovascular disease (iCVD) seems to be neutral in North Europe and North America. The association of 2756 A>G of methionine synthase (MTR), 66 A>G of methionine synthase reductase (MTRR) and 776 C>G of transcobalamin ( TCN2 ) needs to be evaluated further. It was the objective of this study to evaluate the association of these polymorphisms, t-Hcys, vitamin B12 and folate levels with iCVD, in an Italian population from Sicily. We investigated the association of these polymorphisms, t-Hcys, vitamin B12 and folate with iCVD in 252 subjects, including 131 cases and 121 sex- and age-matched healthy controls. t-Hcys was higher in the iCVD group than in controls [15.3 (11.5 - 17.9) vs. 11.6 (9.4 - 14.5) microM; P = 0.0007] and also in subjects with TCN2 776CG genotype, compared to homozygous genotypes [13.5 (9.9 +/- 16.9) vs. 11.7 (9.6 +/- 14.4) microM; P = 0.0327]. The folate level in cases and controls was consistent with an adequate dietary intake [12.7 (9.0 - 15.3) vs. 12.5 (9.6 - 16.9) nM; P = 0.7203]. In multivariate analysis, t-Hcys was a significant independent predictor of iCVD with an odds ratio of 1.14 (95 % C.I.: 1.06 - 1.24; P = 0.0006). No association was found between MTHFR, MTR, MTRR and TCN2 polymorphisms and iCVD risk. We have found an influence of t-Hcys and a neutral effect of MTHFR, MTR, MTRR and TCN2 on iCVD risk in Sicily. The neutral influence of these polymorphisms may be explained by adequate status in folate and vitamin B12. Other factors underlying the increased t-Hcys need further investigations.

Aged↗

The nature of the defect in cobalamin G mutation.

Cobalamin G mutation (cblG) typically presents as a severe megaloblastic anemia during the first few weeks of life. The anemia responds completely to treatment with high doses of Cbl but the neurologic manifestations respond more slowly and not always completely. Cultured fibroblasts from two affected infants and virus-transformed lymphoblasts from one of the infants expressed the following: poor growth in the absence of methionine, the ability to take up and internalize Cbl bound to transcobalamin II, impaired synthesis of methionine from homocysteine, the ability to bind incoming Cbl to the respective coenzymes, but an inability to synthesize methylcobalamin in spite of a normal capacity to synthesize adenosylcobalamin. The in vitro activity of the methyltransferase dependent on methylcobalamin of cell extracts varied from low to high depending on the conditions of culture and assay. The cblG cells were unusually sensitive to the concentration of adenosylmethionine in the assay. More adenosylmethionine was required by cblG cells to achieve the same level of enzyme activity as control cells and high concentrations of adenosylmethionine did not suppress activity as in control cells. It was postulated that the defect in cblG is in the metabolism of adenosylmethionine, an essential substance for the synthesis of methionine from homocysteine.

5-Methyltetrahydrofolate-Homocysteine S-Methyltran↗

[Comparison of two methods of rapid separation of serum trancobalamins (author's transl)].

We have compared different methods for the assay of unsaturated B12 binding capacity of the whole serum and of each of the three transcobalamins (TC I - TC II - TC III). This comparison was important to check the conditions of reproducibility of each method; moreover it has led us to arrive at some modifications to resolve the larger fraction (TC I + TC III) into two distinct components.

Blood Proteins↗

Folic acid, vitamin B12 and vitamin B12 binding proteins in patients with neuroblastoma.

Serum vitamin B12, serum and red cell folate and serum vitamin B12 binding proteins were determined in 18 patients with neuroblastoma, with ages ranging from 8 months to 14 years. A mean value of serum vitamin B12 level was slightly but not significantly lower than that of the normal subjects but all of them had serum vitamin B12 levels over 150 pg/ml. There was no relationship between serum vitamin B12 levels and hemoglobin, hematocrit or white cells. Transcobalamin I (TCI) was significantly increased resulting in slightly elevated UBBC and normal TBBC levels in these patients. This could be a compensatory mechanism for the low serum vitamin B12 by increasing the unsaturated vitamin B12 binding capacity of TCI. All these findings indicated that the status of vitamin B12 in patients with neuroblastoma was within the normal limits. Treatment of neuroblastoma by giving a high dose of vitamin B12 would therefore not give any direct therapeutic effect. Both serum and red cell folate concentrations were significantly lower in the group of patients. As only 2 out of 18 patients had low serum folate and none of them had red cell folate lower than the lower limit of normal subjects; therefore these patients were only in the state of negative folate balance.

Adolescent↗

Cellular fluxes of vitamin B12.

Incorporation of vitamin B12 into L1210 cells requires the protein binder transcobalamin II (TCII). The process is saturable, follows Michaelis-Menten kinetics (Km = 2.5 X 10(-9) M at 37 degrees C), is both temperature and calcium (K50 - 1 X 10(-6) M) dependent, and is inhibited by apo-TCII, indicating the presence of a TCII specific receptor on the cell membrane. B12 also leaves the cell by a calcium-independent pathway bound to either TCII or to a protein with chromatographic properties similar to those of TCIII. Since intact TCII-B12 can be found in the cytosol and can promote B12 uptake by mitochondria, it is proposed that the B12 released from the cell bound to the TCIII-like protein is derived by mitochondrial processing of incorporated TCII-B12. The slower time course of release of the latter B12 is consistent with this postulate.

Animals↗

The availability of therapeutic hydroxocobalamin to cells.

Hydroxocobalamin (OH-Cbl), when used to treat vitamin B12 deficiency, is better retained by the body than is cyanocobalamin (CN-Cbl), but the availability to cells has not been studied systematically. In a series of experiments, we compared the uptake and internalization of OH-Cbl and CN-Cbl bound to transcobalamin II (TCII) by a human cell model, the HeLa cell. TCII-OH-Cbl was: (1) taken up in larger amounts per unit time, (2) the greater uptake was not a consequence of more effective attachment to receptors of TCII-Cbl nor to a more rapid regeneration of receptors, (3) the difference was expressed during the phase of internalization of TCII-Cbl, (4) with CN-Cbl, the stages of binding to receptors plus internalization were more readily reversed, and (5) larger amounts of OH-Cbl were internalized and converted to active coenzyme forms of Cbl. When injected into a healthy person, 200 micrograms of OH-Cbl was better retained in the circulation than 200 micrograms of CN-Cbl. When added in vitro in equivalent amounts, more OH-Cbl was bound to nonspecific plasma proteins. This greater and broader binding neither enhanced nor interfered with the uptake of Cbl by cells, which was determined by the amount of Cbl bound physiologically to TCII. It was concluded that OH-Cbl is a more efficient form of treatment of the common types of Cbl deficiency, principally because of the better retention, which requires less frequent injections, but also because of greater availability to cells.

Animals↗

Cobalamin (vitamin B12) and B12 binding proteins in hypereosinophilic syndromes and secondary eosinophilia.

Serum cobalamin (vitamin B12) and unsaturated B12 binding capacity (UBBC) have been measured in 24 cases of hypereosinophilia: 16 were cases of hypereosinophilic syndrome (HES) and 8 of secondary eosinophilia. The two groups were similar with respect to absolute eosinophil counts. Serum cobalamin and UBBC were found to be markedly increased in most cases of HES and normal in secondary eosinophilia. This elevation of UBBC was mainly related to the increase of R binders (transcobalamins I and III). The elevated serum cobalamin and R binders in HES were due neither to a higher intracellular content of R binders nor to an increased release of these binders from eosinophils of HES. Pure fractions of eosinophils obtained from HES and secondary eosinophilia did not exhibit any difference in vitamin B12 binders. On the other hand, neutrophil-rich fractions from the same patients showed a higher content of intracellular B12 binding proteins than pure eosinophil fractions, irrespective of the cause of eosinophilia. These findings suggest that the increased serum vitamin B12 and UBBC could reflect an expanded pool of both eosinophils and neutrophils in HES and, thus, provide an additional argument for the inclusion of this syndrome in the group of myeloproliferative disorders.

Eosinophilia↗

The biochemical and genetic basis for the microheterogeneity of human R-type vitamin B12 binding proteins.

R-type vitamin B12 binding proteins (R proteins) from human granulocytes, erythrocytes, plasma, and other body fluids were characterized by isoprotein banding patterns on autoradiograms after resolution via thin-layer polyacrylamide isoelectric focusing (IEF) gel electrophoresis. R proteins obtained from various tissue sources in a given individual show tissue-specific electrophoretic patterns. The desialated R proteins obtained following in vitro treatment with neuraminidase are, however, the same for any given individual and do not show tissue specificity. The differences seen in native R proteins (i.e., transcobalamin I, III, and others) obtained from different tissues are due to variations only in the sialic acid content. Granulocytes from patients with chronic myelogenous leukemia (CML) contain both TC I and TC III, and these R proteins can be released in vitro by lithium stimulation. Normal granulocytes contain only TC III. Differences in desialated R proteins from individual to individual are due to a genetic polymorphism controlled by a single genetic locus (designated TCR) with two alleles, 1 and 2, which are found to be codominantly expressed in heterozygous individuals. The allelic variants of the desialated R proteins found in different blood cells and body fluids are controlled by only one genetic locus.

Animals↗

Congenital disorders of vitamin B12 transport and their contributions to concepts. II.

Congenital deficiencies of Transcobalamin II (TC II) and R binders of vitamin B12 (B12, cobalamin, Cbl) have been described in several families. The deficiency of TC II exists as at least three variants. The deficiency of TC II is expressed by a profound megaloblastic pancytopenia during the first few weeks of life, but the serum Cbl is normal. In contrast, the deficiency of R binder is asymptomatic, tissues are replete in Cbl, but the serum Cbl is low. All of the R binder in the several body sources is under the same genetic control. Studies of the congenital deficiency TC II suggest the following: (1) The function of TC II is the promotion of cell uptake of physiologic amounts of Cbl, which can also be accomplished by very large amounts of Cbl, and not in any intracellular process. (2) TC II is essential for the absorption, postabsorptive distribution, and recycling of TC II. (3) The metabolic consequences of TC II deficiency are expressed primarily in rapidly dividing cells probably because they are dependent upon the constant need for new Cbl.

Biological Transport↗

Granulocyte colony-stimulating factor induction of normal human bone marrow progenitors results in neutrophil-specific gene expression.

We have used a combination of hematopoietic growth factors to induce in vitro granulocytic maturation. A fraction of marrow cells enriched for hematopoietic progenitor cells (CD34+, HLA-DR+) was isolated from normal human bone marrow by monoclonal antibody staining and fluorescence-activated cell sorting. Cells were cultured in a suspension system for 3 days in the presence of stem cell factor and interleukin-3 (IL-3), after which granulocyte colony-stimulating factor (G-CSF) was added. Cells were harvested daily and analyzed for phenotypic maturation by morphologic criteria, and total RNA was obtained for analysis of myeloid gene expression. Maturation was observed to progress to the late metamyelocyte and band stage over a period of 10 to 12 days. Neutrophil-specific gene expression was assayed by reverse transcription-polymerase chain reaction (RT-PCR). Induction with G-CSF resulted in sequential expression of primary and secondary granule proteins, with asynchronous expression of primary granule proteins starting from days 1 to 5, and synchronous expression of lactoferrin and transcobalamin I (secondary granule proteins) from days 7 to 8. Interestingly, myeloperoxidase (MPO) mRNA expression was easily detected in both the freshly isolated CD34+, HLA-DR+ cells and cells at all subsequent stages of induction. This suggests that MPO mRNA is expressed very early during neutrophil development, perhaps before the development of significant numbers of phenotypically recognizable granules. This recapitulation of a program of sequential expression of primary and secondary granule protein genes suggests that in vitro marrow culture suspensions to which appropriate growth factors are added can mimic normal granulocytic maturation. This system should provide an important model for the study of neutrophil-specific gene expression.

Antigens, CD↗

[Absorption, distribution and excretion of vitamin B12].

During our first communication [1], the complexity of vitamin B12 digestive transport was considered. This second presentation demonstrates the route of the vitamin in the body. As cobalamin or vitamin B12 has existed for four billion years, they figure without any doubt amongst those molecules which have the most complex structure. The rarity of an architecture organised around a cobalt atom confirms their high level of originality. Their exceptional character is reflected in their cycle such as for mammals and for man where the intervention of binders, such as intrinsic factor, transcobalamin and haptocorrin is necessary for transporting them. As far as cellular metabolism is concerned, it is especially loaded sometimes with folates in the transfer of the methyl group. The molecules are spiked with hydrophobic sites. Their membrane transfer is facilitated by several types of receptors. The intestinal absorption, which appears to require the presence of two receptors and two transporters, remains for the moment a unique assimilation model. The very probable existence of an enterohepatic cycle as well as a renal reabsorption saves this molecule, itself synthesised by microorganisms only.

Adult↗

The individual regulation of granule protein mRNA levels during neutrophil maturation explains the heterogeneity of neutrophil granules.

The in vivo mRNA levels for 16 granule proteins during neutrophil differentiation were determined to address the question of whether the synthesis of granule proteins is regulated individually or blockwise. RNA was extracted from peripheral blood granulocytes and three different populations of neutrophil precursors isolated from human bone marrow by Percoll density centrifugation. The mRNA levels in relation to the maturation of the cells were determined by Northern blot for the 12 matrix proteins myeloperoxidase, proteinase-3, elastase, defensin, lactoferrin, NGAL, hCAP-18, transcobalamin-I, SGP28, gelatinase, lysozyme, and serglycin and the 4 membrane proteins CD68, CD11b, N-formyl-methionyl-leucyl-phenylalanine receptor, and CD35. This panel of transcripts ensured that markers for all exocytosable organelles of the neutrophil were included in the study. A highly differentiated distribution of mRNAs for granule proteins was demonstrated that can explain the heterogeneity of the intracellular storage granules and secretory vesicles of the neutrophil. Furthermore, the individual distribution of these transcripts provides the basis for a more detailed assessment of neutrophil maturation than that obtained by morphological studies or the use of a single marker protein for azurophil, specific, and gelatinase granules.

Blood Proteins↗

Vitamin B12 metabolism and status during pregnancy, lactation and infancy.

This overview of vitamin B12 metabolism and requirements during the continuum of pregnancy and lactation has identified several gaps in our knowledge. More information is needed concerning the roles of the different transcobalamins during pregnancy and lactation, including their impact on placental and mammary transfer of cobalamin and their effect on intestinal absorption in the infant. Knowledge is needed about the relative importance of maternal stores and current dietary intake on fetal storage of the vitamin, and on its concentration in breast milk. Because there is some evidence that infant's urinary methylmalonic acid excretion is reduced by intakes slightly higher than the current RDA, the adequacy of the current RDA for vitamin B12 during infancy should be verified. Finally, it is possible that vitamin B12 deficiency is more common in pregnant and lactating women and their young children in developing countries than has been recognized previously, due primarily to malabsorption. It is important to confirm whether or not this is the case, in view of its potential impact on infant neurobehavioral development and the relative ease with which supplements of the vitamin could be provided.

Developing Countries↗

The murine leukemia inhibition factor gene (Lif) is located on proximal chromosome 11, not chromosome 13.

Lif, the murine gene encoding leukemia inhibition factor (LIF), has been previously localized to proximal Chromosome (Chr) 11. Hilda, the murine gene encoding "human interleukin in DA cells" (HILDA) has been localized to Chr 13. Since these two growth factors are identical, the proposal for two different structural loci is intriguing. To address this issue, blot hybridization methods have been used to establish the position of the structural gene sequence unambiguously. DNAs from somatic cell hybrids, recombinant inbred mice, and backcross mice have been probed with a sequence that encodes LIF/HILDA. The results support the assignment of this sequence to proximal Chr 11. These studies also establish a synteny group, including Lif and Tcn-2, the structural gene for transcobalamin 2, that is conserved between man and mouse.

Animals↗

Genetic polymorphism of vitamin B12 binding (R) proteins of human saliva detected by isoelectric focusing.

Genetic polymorphism of the vitamin B12 binding (R) proteins of parotid saliva is determined by autosomal inheritance of codominant alleles. This hypothesis is supported by studies in 43 families including 152 children. For randomly collected salivas from 143 whites, 104 blacks, and 75 Chinese, gene frequencies are as follows: for whites, Rs1=0.88, Rs2=0.12; for blacks, Rs1=0.94, Rs2=0.06; for Chinese, Rs1=1.00. This genetic marker is also shared by R proteins of milk, tears, and leukocytes. In the Rs 1--2 salivary type there is less labeling of the protein products of Rs2 v. Rs1 with 57Co B12 as assessed by the intensity of the bands on the autoradiogram. There is no evidence for close linkage (theta less than 0.01) between Rs and TC II (transcobalamin II) or between Rs and salivary protein locus Pr, Db, Gl, or Ps.

Carrier Proteins↗

Acute promyelocytic leukemia. A review of literature.

Acute promyelocytic leukemia is a form of acute myeloblastic leukemia characterized by hemorrhagic episodes, severe thrombocytopenia and infiltration of the marrow with "hypergranular" promyelocytes, often with multiple Auer bodies. Ultrastructurally. the promyelocytes show many splinter granules and Auer bodies with characteristic hexagonal arrangement of tubules with a periodicity of 250 A. Serum vitamin B12 and B12-binding proteins, in particular, transcobalamin I, are abnormally high. Karyotypic abnormalities include pseudodiploidy and partial deletion of the long arm of chromosome 17. Coagulation profile during bleeding episodes is usually consistent with disseminated intravascular coagulation. Greatly improved prognosis in recent years as a result of aggressive chemotherapy and anticoagulation emphasizes the need of early recognition of this clinical entity.

Adult↗

Lysosomal cobalamin accumulation in fibroblasts from a patient with an inborn error of cobalamin metabolism (cblF complementation group): visualization by electron microscope radioautography.

Cobalamin (Cbl, vitamin B12) bound to transcobalamin II (TCII) enters cultured fibroblasts by receptor-mediated endocytosis. Following degradation of the TCII, Cbl is subsequently found in either the cytoplasm bound to methionine synthase or in the mitochondria bound to methylmalonyl CoA mutase. In fibroblasts from patients belonging to the cblF complementation group, Cbl is found free in the cell and is not transferred to the above two target enzymes. Quantitative EM radioautography was utilized to visualize intracellular Cbl in fibroblasts from cblF patients and from normal subjects. In cblF cells, 60% of all silver grains were assigned to lysosomes, with only 12.6% over cytoplasm and 1.2% over mitochondria. In contrast, in control cells, only 4.7% were assigned to lysosomes, with 47% to cytoplasm and 23.4% to mitochondria. Subcellular fractionation showed that in cblF cells, the majority of label was associated with clearly recognizable lysosomes. These studies conclusively demonstrate that secondary lysosomes accumulate Cbl in cblF disease.

Autoradiography↗

The transport of vitamin B12 through polarized monolayers of Caco-2 cells.

Caco-2 cells grown on 0.45-micron filters, in Millicell chambers, form intact monolayers with many of the properties of polarized intestinal epithelial cells. It is reported here that these cells bind and internalize intrinsic factor-cobalamin complexes and that after 14-28 days in culture this specific binding is exclusively located on the apical membrane. Caco-2 cells also synthesize and secrete a protein with properties similar to transcobalamin II. This protein is secreted from the basolateral side of the cells after 20 days in culture. Specific apical-to-basolateral transcellular transport of [57Co]cobalamin also occurs between 20 and 28 days in culture. Thus, Caco-2 cells provide the first polarized human cell system for studying the transepithelial transport of cobalamin.

Biological Transport↗