Studies on the mechanism of action of chemotherapeutic agents in cancer. II. Requirements for the prevention of aminopterin toxicity by folic acid in mice.
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BACKGROUND: This trial sought to examine the effects of high dosage of folic acid and vitamin C supplementation on red blood cell folate (RCF), serum folate (SF) and homocysteine (Hcy) levels in subjects who smoke more than 15 cigarettes per day. METHODS: A prospective study of 100 Italian repeat blood donors was undertaken to measure RCF, SF and Hcy levels before and after 45 days of vitamin supplementation. All subjects were randomised into four groups: [A] folic acid (FA) 5 mg/day, [B] vitamin C 500 mg/day, [C] FA 5 mg/day plus vitamin C 500 mg/day [D] no supplementation. RESULTS: Before supplementation the median RCF, SF and Hcy levels were similar in the four groups; 32 (40%) subjects had an RCF level below 340 nmol/l, 15 (18.8%) had an SF level below 6.8 nmol/l and 21 (26.3%) had an Hcy level above 16 micromol/l. After 45 days the median RCF and SF levels were significantly (P<0.01) increased in all supplemented subjects. The median Hcy level was significantly (P=0.008) reduced in subjects supplemented with FA and significantly (P=0.01) increased in those supplemented with vitamin C alone. CONCLUSION: The supplementation with 5 FA mg/day is able to increase significantly both RCF and SF levels and reduce Hcy level in Italian smoker-blood donors.
Administration of 100 and 200 microg/ml of cisplatin [cis -diammine dichloro platinum (II)] for 1 h to growing Dictyostelium discoideum cells severely affects folic acid chemotaxis and phagocytotic function in this organism. Following cisplatin treatment, cells show a much lower uptake of FITC labelled bacteria and a reduced plaque forming ability when plated on Eschericia coli seeded normal agar. Folic acid chemotaxis and folate deaminase activity are greatly inhibited in cisplatin-treated Dictyostelium cells. SDS-PAGE analysis shows a greater association of actin and myosin with the cell cortex of treated cells. These results have been discussed in relation to cisplatin's known ability to raise the levels of cytosolic calcium.
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The FDA's decision to require the fortification of the United State's grain supply with folic acid was made complex by proponents' arguments for its protective properties against neural tube defects (NTD) vs. opponents' concern regarding safety-risks in masking vitamin B12 deficiency in the elderly. Since this regulation mandated an effective date of January 1, 1998, research has been conducted to identify the impact that the fortification of 140 micrograms/100 g of grain in the U.S. grain supply has had on public health. Studies attempted to more accurately describe the minimum effective dose for prevention of NTD and to identify the levels at which it presents a health risk. Several studies have been reviewed and recommendations have been provided for altering the level of folic acid fortification.
There a few birth defects known to be preventable, but neural tube defects (NTDs) are one group of congenital anomalies that can potentially be prevented. When 400 micrograms of maternal periconceptional folic acid is taken daily, it can prevent many neural tube-related birth defects and thus reduce morbidity and mortality due to these birth defects. Health care providers should encourage every woman of reproductive age to consume 400 micrograms of synthetic folic acid daily, not just those who are planning a pregnancy. Supplementation needs to be started prior to conception for optimal effectiveness.
Monozygous twin 14-year-old mentally retarded boys with the fragile X syndrome were treated either with 10 mg folic acid by mouth daily or with a placebo for three test periods of 3-month duration each in a blind study. For each twin, tests of cognitive functioning, reading, spelling, and math skills, and linguistic and perceptual skills were compared. Although there was considerable variation in performance on these tests during the two baseline periods, there were no observable beneficial effects of therapy. The routine use of folic acid in patients with established mental retardation and the fragile X syndrome is not indicated.
BACKGROUND: To decrease the risk of neural tube defects, all women planning pregnancy or capable of becoming pregnant should take folic acid supplements. The aim of the study was to describe the association between pregnancy planning and vitamin supplement use. METHODS: A total of 1,858 pregnant women registered for a prenatal ultrasound examination in the Montérégie region, Province of Quebec, Canada, completed a questionnaire between November 1997 and May 1998. Pregnancy planning was described by six ordinal variables, which were included in a nonlinear principal component analysis. The main dimension representing the intensity of pregnancy planning was used as the dependent variable in a multivariate linear regression model, and as a basis for assessing vitamin use according to four levels of planning. RESULTS: A majority of women scored high for intensity of pregnancy planning. Planning intensity score increased with age and was higher among women who attended university, had a family income greater than CAD $30,000, and were married. Vitamin use in the period prior to conception occurred with a frequency of 27.5%, increasing moderately with planning intensity scores. Overall, only 13.5% of fetuses were exposed to adequate doses of folic acid. CONCLUSION: A promotion campaign selectively targeting women likely to plan a pregnancy could have a significant impact in reducing neural tube defect incidence.
The folate in milk is largely bound to high-affinity folate-binding protein (FBP). With an in vivo intestinal loop technique, we examined the absorption of folic acid bound to FBP (FA-FBP) in the small intestine of the suckling rat. In contrast to unbound folic acid (FA), FA-FBP is absorbed more avidly in the ileum than in the jejunum (p less than 0.025) and its absorption is not inhibited by 1 mmol sulfasalazine/L. Folate-binding activities in the mucosa of the proximal (duodenum and jejunum combined) and distal (ileum) small intestine were also examined and found to be 0.32 and 1.31 pmol/mg protein, respectively (p less than 0.001). A 6-h fast produced a 42% decrease in folate-binding activity in the distal small intestine (p less than 0.01) but did not change activity in the proximal portion. Collectively, these observations suggest that FA-FBP is absorbed by a mechanism that is distinct from that responsible for the absorption of FA and that absorption does not require prior dissociation of the vitamin-binding protein complex.
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