Metabolism and gene polymorphisms of the folate pathway in Brazilian women with history of recurrent abortion / Metabolismo e polimorfismos gênicos da via do folato em mulheres brasileiras com história de aborto recorrente

PURPOSE: To investigate the association between polymorphisms in genes that encode enzymes involved in folate- and vitamin B12-dependent homocysteine metabolism and recurrent spontaneous abortion (RSA). METHODS: We investigated the C677T and A1298C polymorphisms of the methylenetetrahydrofalate reductase gene (MTHFR), the A2756G polymorphism of the methionine synthase gene (MS) and the 844ins68 insertion of the cystathionine beta synthetase gene (CBS). The PCR technique followed by RFLP was used to assess the polymorphisms; the serum levels of homocysteine, vitamin B12 and folate were investigated by chemiluminescence. The EPI Info Software version 6.04 was used for statistical analysis. Parametric variables were compared by Student's t-test and nonparametric variables by the Wilcoxon rank sum test. RESULTS: The frequencies of gene polymorphisms in 89 women with a history of idiopathic recurrent miscarriage and 150 controls were 19.1 and 19.6% for the C677T, insertion, 20.8 and 26% for the A1298C insertion, 14.2 and 21.9% for the A2756G insertion, and 16.4 and 18% for the 844ins68 insertion, respectively. There were no significant differences between case and control groups in any of the gene polymorphisms investigated. However, the frequency of the 844ins68 insertion in the CBS gene was higher among women with a history of loss during the third trimester of pregnancy (p=0.003). Serum homocysteine, vitamin B12 and folate levels id not differ between the polymorphisms studied in the case and control groups. However, linear regression analysis showed a dependence of serum folate levels on the maintenance of tHcy levels. CONCLUSION: The investigated gene polymorphisms and serum homocysteine, vitamin B12 and folate levels were not associated with idiopathic recurrent miscarriage in the present study. Further investigations are needed in order to confirm the role of the CBS 844ins68 insertion in recurrent miscarriage. .

OBJETIVO: Investigar a associação entre polimorfismos nos genes que codificam enzimas envolvidas no metabolismo da homocisteína dependente de folato e vitamina B12 e aborto espontâneo recorrente. MÉTODOS: Investigamos os polimorfismos C677T e A1298C no gene methilenotetrahidrofalato redutase (MTHFR); o polimorfismo A2756G no gene metionina sintase (MS) e a inserção 844ins68 no gene da cistationina beta-sintetase (CBS). A técnica de PCR seguido por RFLP foi utilizada para investigar os polimorfismos. Os níveis séricos de homocisteína, vitamina B12 e de folato foram investigados pela técnica de quimioluminescência. O Software Epi Info versão 6.04 foi utilizado para realizar a análise estatística. As variáveis paramétricas foram comparadas pelo teste t de Student e as variáveis não paramétricas pelo teste de Wilcoxon rank sum. RESULTADOS: As frequências dos polimorfismos gênicos em 89 mulheres com história de aborto recorrente idiopático e 150 controles foram de 19,1 e 19,6% para o C677T; 20,8 e 26% para o A1298C; 14,2 e 21,9% para o A2756G e 16,4 e 18% para a inserção 844ins68, respectivamente. Não houve diferenças significantes entre os grupos caso e controle em todos os polimorfismos dos genes investigados. No entanto, a frequência da inserção 844ins68 no gene CBS foi maior entre mulher com histórico de perdas no terceiro trimestre da gravidez p=0.003). Os níveis de homocisteína, vitamina B12 e folato séricos não foram diferentes entre os polimorfismos estudados nos grupos casos e controles. No entanto, a análise de regressão linear mostrou dependência dos níveis séricos de folato na manutenção dos níveis de homocisteína. CONCLUSÃO: Os polimorfismos gênicos investigados, assim como homocisteína, vitamina B12 e os níveis séricos de folato não foram associados com abortos recorrentes idiopático no presente estudo. Novas investigações devem ser realizados a fim de confirmar o papel da inserção 844ins68-CBS nos abortos recorrentes. .

Vitamin B12 and folate depletion in cognition: a review.

In cross-sectional studies, low levels of folate and B12 have been shown to be associated with cognitive decline and dementia Evidence for the putative role of folate, vitamin B12 in neurocognitive and other neurological functions comes from reported cases of severe vitamin deficiencies, particularly pernicious anemia, and homozygous defects in genes that encode for enzymes of one-carbon metabolism. The neurological alterations seen in these cases allow for a biological role of vitamins in neurophysiology. Results are quite controversial and there is an open debate in literature, considering that the potential and differential role of folate and B12 vitamin in memory acquisition and cognitive development is not completely understood or accepted. What is not clear is the fact that vitamin B12 and folate deficiency deteriorate a pre-existing not overt pathological situation or can be dangerous even in normal subjects. Even more intriguing is the interaction between B12 and folate, and their role in developing hyperhomocysteinemia. The approach to the rehabilitation of the deficiency with adequate vitamin supplementation is very confusing. Some authors suggest it, even in chronic situations, others deny any possible role. Starting from these quite confusing perspectives, the aim of this review is to report and categorize the data obtained from the literature. Despite the plausible biochemical mechanism, further studies, based on clinical, neuropsychological, laboratory and (lastly) pathological features will be necessary to better understand this fascinating biochemical riddle.

Acido Fólico y Vitamina B12 en la nutrición humana / Folic acid and vitamin B12 in human nutrition

La malnutrición es la causa más común de la defiencia de ácido fólico y cobalamina. La magnitud real de la deficiencia de folato no es bien conocida y la mayoría de las cifras están derivadas de la frecuencia de anemia en el embarazo; la deficiencia de cobalamina tiene mayor incidencia en los vegetarianos estrictos. Se estima que sólo la mitad del folato total de la dieta está disponible para ser absorbido. La cocción de los alimentos en grandes volúmenes de líquido destruye el folato de los vegetales verdes y de la carne, también se pueden perder así cantidades significativas de cobalamina. Por su implicación en las síntesis de ADN, ARN y el metabolismo de algunos aminoácidos, la defiencia de ácido fólico en el embarazo, principalmente antes del cierre del tubo neural, puede ocasionar daños en la formación de la médula espinal y el cerebro conduciendo a la aparición de anencefalia, espina bífida y encefalocele. La homocisteína como metabolito intermediario de la metionina y que requiere ácido fólico y cobalimina, se ha descrito como factor de riesgo para las enfermedades cardiovasculares. El envejecimiento está acompañado por un incremento del riesgo de deficiencia de cobalamina. Muchos adultos mayores sin antecedentes de anemia perniciosa tienen deficiencias clínicas o subclínicas de cobalamina, aparentemente debido a otros problemas de absorción

Detección de aciduria metilmalónica mediante pruebas de tamizaje metabólico / Detection of methylmalonic aciduria by means of metabolic screening

La búsqueda de aciduria metilmalónica es uno de los procedimientos en el Programa de Detección de Errores Congénitos del Metabolismo que se realiza en varias unidades del IMSS en Monterrey, Nuevo León, para estudiar muestras procedentes de personas con sospecha de enfermedad metabólica genética. De un total de 2100 exámenes realizados en pacientes pediátricos, cinco resultaron positivos mediante la prueba del color y en todos ellos se corroboró la presencia del ácido metilmalónico mediante cromatografía A1 de celusosa. Aunque no se obtuvo diagnóstico de precisión, es probable que más de una forma del padecimiento exista en nuestro medio. Debido a la gravedad de este defecto, a la posibilidad del manejo médico y la conveniencia del asesoramiento genético en las familias portadoras, se justifica este tipo de detección en las unidades pediátricas o de atención materno-infantil.

An indirect role of vitamin B12 in regulation of thymidylate synthase in Lactobacillus leichmannii.

Vitamin B12 augments thymidylate synthase function in L. leichmannii by facilitating indirectly the availability of suitable nonmethylpolyglutamylfolate cofactors. This is effected by the demethylation of trapped methyltetrahydrofolates, catalysed by a vitamin B12 requiring methionine synthase. Deoxyuridine supplemented cells, lacking in B12, have decreased levels of methionine synthase and thymidylate synthase. Addition of active and inactive conjugase preparation as a source of mono and polyglutamylfolates indicated that the latter are the preferred cofactors for thymidylate synthase.