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1.
Curr Opin Clin Nutr Metab Care ; 23(4): 241-246, 2020 07.
Article in English | MEDLINE | ID: mdl-32412981

ABSTRACT

PURPOSE OF REVIEW: Immune dysfunction, including severe combined immunodeficiency, has been described in genetic disorders affecting the metabolism of the vitamins cobalamin (vitamin B12) and folate. We have reviewed reports of clinical findings in patients with a number of inborn errors of cobalamin or folate metabolism, specifically looking for immune problems. RECENT FINDINGS: There is little evidence that immune function is affected in most of the disorders. Exceptions are Imerslund-Gräsbeck syndrome and hereditary folate malabsorption (affecting intestinal absorption of cobalamin and folate, respectively), transcobalamin deficiency (affecting transport of cobalamin in blood and cellular cobalamin uptake), and methylenetetrahydrofolate dehydrogenase 1 deficiency (catalyzing cytoplasmic interconversion of reduced folate coenzyme derivatives). SUMMARY: Although some inborn errors of cobalamin or folate can be associated with immune dysfunction, the degree and type of immune dysfunction vary with no obvious pattern.


Subject(s)
Folic Acid Deficiency/immunology , Malabsorption Syndromes/immunology , Nutritional Physiological Phenomena/immunology , Primary Immunodeficiency Diseases/immunology , Vitamin B 12 Deficiency/immunology , Anemia, Megaloblastic/congenital , Anemia, Megaloblastic/immunology , Folic Acid/genetics , Folic Acid/immunology , Folic Acid Deficiency/congenital , Humans , Malabsorption Syndromes/congenital , Methylenetetrahydrofolate Dehydrogenase (NADP)/deficiency , Methylenetetrahydrofolate Dehydrogenase (NADP)/immunology , Minor Histocompatibility Antigens/immunology , Proteinuria/congenital , Proteinuria/immunology , Transcobalamins/deficiency , Transcobalamins/immunology , Vitamin B 12/genetics , Vitamin B 12/immunology , Vitamin B 12 Deficiency/congenital
2.
J Cell Mol Med ; 23(7): 4795-4807, 2019 07.
Article in English | MEDLINE | ID: mdl-31087489

ABSTRACT

Recent studies revealed that folic acid deficiency (FD) increased the likelihood of stroke and aggravated brain injury after focal cerebral ischaemia. The microglia-mediated inflammatory response plays a crucial role in the complicated pathologies that lead to ischaemic brain injury. However, whether FD is involved in the activation of microglia and the neuroinflammation after experimental stroke and the underlying mechanism is still unclear. The aim of the present study was to assess whether FD modulates the Notch1/nuclear factor kappa B (NF-κB) pathway and enhances microglial immune response in a rat middle cerebral artery occlusion-reperfusion (MCAO) model and oxygen-glucose deprivation (OGD)-treated BV-2 cells. Our results exhibited that FD worsened neuronal cell death and exaggerated microglia activation in the hippocampal CA1, CA3 and Dentate gyrus (DG) subregions after cerebral ischaemia/reperfusion. The hippocampal CA1 region was more sensitive to ischaemic injury and FD treatment. The protein expressions of proinflammatory cytokines such as tumour necrosis factor-α, interleukin-1ß and interleukin-6 were also augmented by FD treatment in microglial cells of the post-ischaemic hippocampus and in vitro OGD-stressed microglia model. Moreover, FD not only dramatically enhanced the protein expression levels of Notch1 and NF-κB p65 but also promoted the phosphorylation of pIkBα and the nuclear translocation of NF-κB p65. Blocking of Notch1 with N-[N-(3, 5-difluorophenacetyl)-l-alanyl]-S-phenylglycine t-butyl ester partly attenuated the nuclear translocation of NF-κB p65 and the protein expression of neuroinflammatory cytokines in FD-treated hypoxic BV-2 microglia. These results suggested that Notch1/NF-κB p65 pathway-mediated microglial immune response may be a molecular mechanism underlying cerebral ischaemia-reperfusion injury worsened by FD treatment.


Subject(s)
Brain Injuries/complications , Brain Ischemia/complications , Folic Acid Deficiency/immunology , Hippocampus/metabolism , Microglia/immunology , Receptor, Notch1/metabolism , Signal Transduction , Transcription Factor RelA/metabolism , Animals , Brain Injuries/metabolism , Brain Injuries/pathology , Brain Ischemia/metabolism , Brain Ischemia/pathology , Cell Line , Cytokines/metabolism , Dipeptides/pharmacology , Glucose/deficiency , Infarction, Middle Cerebral Artery/complications , Inflammation/pathology , Male , Mice , Microglia/drug effects , Neurons/drug effects , Neurons/pathology , Oxygen , Rats, Sprague-Dawley , Signal Transduction/drug effects
3.
J Nutr Biochem ; 41: 65-72, 2017 03.
Article in English | MEDLINE | ID: mdl-28040582

ABSTRACT

Insufficient folate status may be related to the increasing prevalence of immune- or inflammation-related chronic diseases. To investigate the effects of folate on immune regulation, we examined the impact of folate deficiency (FD) on dendritic cell (DC) maturation and function and, thus, T helper (Th) cells differentiation. First, bone marrow-derived DCs (BMDCs) were generated from BALB/c mice bone marrow cells cultured in folate-containing (F-BMDCs) or folate-deficient (FD-BMDCs) medium. FD-BMDC displayed more immature phenotype including reduced levels of major histocompatibility complex class II (MHC II), co-stimulatory molecules and characteristic of higher endocytic activity. FD-BMDC produced less IL-12p70 and proinflammatory cytokines in response to lipopolysaccharide. This aberrant DC maturation due to FD resulted in reduced BMDC-induced Th cell activity and lower IL-2, IFNγ, IL-13 and IL-10 productions. Further in vivo study confirmed significantly lower IFNγ and IL-10 productions by T cells and showed higher splenic naïve Th and lower memory T, effector T and regulatory T cell (Treg) percentages in mice fed with the FD diet for 13 weeks. To investigate the role of DCs on T cell activity, splenic DCs (spDC) from FD mice were cocultured with Th cells. The FD spDC had lower MHC II and CD80 expressions and subsequently impaired DC-induced Th differentiation, shown as decreased cytokine productions. This study demonstrated that folate deficiency impaired DC functions and, thus, Th differentiation and responses, suggesting that folate plays a crucial role in maintaining Th cells homeostasis.


Subject(s)
Dendritic Cells/pathology , Endocytosis , Folic Acid Deficiency/pathology , T-Lymphocytes, Helper-Inducer/pathology , Animals , Bone Marrow Cells/drug effects , Bone Marrow Cells/immunology , Bone Marrow Cells/metabolism , Bone Marrow Cells/pathology , Cell Differentiation/drug effects , Cells, Cultured , Coculture Techniques , Cytokines/genetics , Cytokines/metabolism , Dendritic Cells/drug effects , Dendritic Cells/immunology , Dendritic Cells/metabolism , Endocytosis/drug effects , Female , Folic Acid Deficiency/immunology , Gene Expression Regulation/drug effects , Lipopolysaccharides/toxicity , Mice, Inbred BALB C , Reproducibility of Results , Spleen/drug effects , Spleen/immunology , Spleen/metabolism , Spleen/pathology , T-Lymphocytes, Helper-Inducer/drug effects , T-Lymphocytes, Helper-Inducer/immunology , T-Lymphocytes, Helper-Inducer/metabolism , T-Lymphocytes, Regulatory/drug effects , T-Lymphocytes, Regulatory/immunology , T-Lymphocytes, Regulatory/metabolism , T-Lymphocytes, Regulatory/pathology
4.
J Formos Med Assoc ; 116(3): 145-152, 2017 Mar.
Article in English | MEDLINE | ID: mdl-27825814

ABSTRACT

BACKGROUND/PURPOSE: Serum anti-gastric parietal cell (GPCA), anti-thyroglobulin (TGA), and anti-thyroid microsomal antibodies (TMA) can be found in some recurrent aphthous stomatitis (RAS) patients. This study mainly assessed whether serum GPCA, TGA, TMA and RAS itself played significant roles in causing anemia and hematinic deficiencies in TGA/TMA-positive RAS patients with GPCA positivity (GPCA+/TGA/TMA/RAS patients) or negativity (GPCA-/TGA/TMA/RAS patients). METHODS: The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, and folic acid levels were measured and compared between any two of the four groups of 15 GPCA+/TGA/TMA/RAS patients, 69 GPCA-/TGA/TMA/RAS patients, 240 all autoantibodies-negative RAS patients (Abs-/RAS patients), and 342 healthy control subjects. RESULTS: GPCA+/TGA/TMA/RAS patients had significantly lower mean Hb (for men only) and vitamin B12 levels as well as significantly greater frequencies of Hb, iron, and vitamin B12 deficiencies than healthy control subjects. GPCA+/TGA/TMA/RAS patients had lower serum vitamin B12 level and higher MCV as well as a significantly greater frequency of vitamin B12 deficiency than GPCA-/TGA/TMA/RAS patients. Furthermore, both GPCA-/TGA/TMA/RAS and Abs-/RAS patients did have significantly lower mean Hb, MCV, and iron levels as well as significantly greater frequencies of Hb, iron and vitamin B12 deficiencies than healthy control subjects. There were no significant differences in blood data between GPCA-/TGA/TMA/RAS and Abs-/RAS patients CONCLUSION: Both serum GPCA positivity and RAS itself are the contributing factors causing anemia and hematinic deficiencies in GPCA+/TGA/TMA/RAS patients. RAS itself but not TGA/TMA positivity plays a significant role in causing anemia and hematinic deficiencies in GPCA-/TGA/TMA/RAS patients.


Subject(s)
Anemia, Iron-Deficiency/complications , Anemia, Pernicious/complications , Folic Acid Deficiency/blood , Stomatitis, Aphthous/blood , Adult , Aged , Aged, 80 and over , Anemia, Iron-Deficiency/immunology , Anemia, Pernicious/immunology , Autoantibodies/blood , Case-Control Studies , Erythrocyte Indices , Female , Folic Acid/blood , Folic Acid Deficiency/immunology , Hemoglobins/analysis , Humans , Iron/blood , Male , Middle Aged , Parietal Cells, Gastric/immunology , Stomatitis, Aphthous/immunology , Taiwan , Vitamin B 12/blood
5.
Fish Shellfish Immunol ; 51: 405-419, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26968494

ABSTRACT

This investigation used the same growth trial as the previous study, which showed that folic acid deficiency retarded growth in young grass carp (the percent weight gain of Groups 1-6 were 102.32 ± 3.41%, 137.25 ± 10.48%, 179.78 ± 3.95%, 164.33 ± 3.21%, 143.35 ± 8.12% and 115.28 ± 2.66%) [1]. In the present study, we investigated the effects of dietary folic acid on the immune response, antioxidant status and tight junctions in the intestine of young grass carp (Ctenopharyngodon idella). A total of 540 young grass carp were fed diets containing graded levels of folic acid at 0.10, 0.47, 1.03, 1.48, 1.88 and 3.12 mg kg(-1) diet for 8 weeks. The results indicated that acid phosphatase and lysozyme activities, and the complement component 3 content in the proximal intestine (PI), mid intestine (MI) and distal intestine (DI) were decreased with folic acid deficiency (0.1 mg kg(-1)) (P < 0.05). Folic acid deficiency (0.1 mg kg(-1)) up-regulated interleukin 1ß, interleukin 8, tumor necrosis factor α, nuclear factor κB p65 (NF-κB p65), IκB kinase α (IKK-α), IKK-ß and IKK-γ gene expression, meanwhile down-regulated interleukin 10, transforming growth factor ß, IκB and target of rapamycin gene expression in the PI, MI and DI (P < 0.05). These data suggested that folic acid deficiency decreased fish intestinal innate immune function may be partly contributed to the regulation of NF-κB p65 pathway. Moreover, the activities and corresponding gene expression of glutathione content, Cu/Zn superoxide dismutase, catalase, glutathione peroxidase, glutathione s-transferases and glutathione reductase in fish intestine were depressed by deficient folic acid diet (0.1 mg kg(-1)) (P < 0.05). Furthermore, folic acid deficiency (0.1 mg kg(-1)) down-regulated NF-E2-related factor 2 (Nrf2) gene expression, up-regulated Kelch-like-ECH-associated protein 1a (Keap1a) and Keap1b gene expression in fish intestine (P < 0.05). These data indicated that deficient folic acid diet damaged fish intestinal antioxidant capacity partly by regulating Nrf2/Keap1 pathway. Additionally, folic acid deficiency (0.1 mg kg(-1)) down-regulated claudin-b, claudin-c, claudin-3, occludin and zonula occludens 1 gene expression; whereas folic acid deficiency (0.1 mg kg(-1)) up-regulated claudin-12, claudin-15, myosin light chain kinase (MLCK) and p38 mitogen activated protein kinase (p38 MAPK) gene expression in the PI, MI and DI (P < 0.05), suggesting that folic acid deficiency may damage fish intestinal tight junctions associated with the mediation of MLCK and p38 MAPK gene expression. In conclusion, folic acid deficiency (0.1 mg kg(-1)) impaired fish intestinal immunity, antioxidant capacity and tight junctions.


Subject(s)
Carps/immunology , Folic Acid Deficiency/immunology , Intestines/immunology , Animals , Carps/metabolism , Catalase/metabolism , Cytokines/genetics , Fish Proteins/genetics , Fish Proteins/metabolism , Folic Acid Deficiency/metabolism , Folic Acid Deficiency/veterinary , Glutathione/metabolism , Glutathione Peroxidase/metabolism , Glutathione Reductase/metabolism , I-kappa B Kinase/genetics , Intestinal Mucosa/metabolism , Malondialdehyde/metabolism , Myosin-Light-Chain Kinase/genetics , NF-E2-Related Factor 2/genetics , NF-kappa B/genetics , RNA, Messenger/metabolism , Reactive Oxygen Species/metabolism , TOR Serine-Threonine Kinases/genetics , Tight Junction Proteins/genetics , p38 Mitogen-Activated Protein Kinases/genetics
6.
Birth Defects Res A Clin Mol Teratol ; 106(3): 201-7, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26900104

ABSTRACT

BACKGROUND: Periconceptional supplementation with folic acid results in a significant reduction in the incidence of neural tube defects (NTDs). Nonetheless, NTDs remain a leading cause of perinatal morbidity and mortality worldwide, and the mechanism(s) by which folate exerts its protective effects are unknown. Homocysteine is an amino acid that accumulates under conditions of folate-deficiency, and is suggested as a risk factor for NTDs. One proposed mechanism of homocysteine toxicity is its accumulation into proteins in a process termed homocysteinylation. METHODS & RESULTS: Herein, we used a folate-deficient diet in pregnant mice to demonstrate that there is: (i) a significant inverse correlation between maternal serum folate levels and serum homocysteine; (ii) a significant positive correlation between serum homocysteine levels and titers of autoantibodies against homocysteinylated protein; and (iii) a significant increase in congenital malformations and NTDs in mice deficient in serum folate. Furthermore, in mice administered the folate-deplete diet before conception, supplementation with folic acid during the gestational period completely rescued the embryos from congenital defects, and resulted in homocysteinylated protein titers at term that are comparable to that of mice administered a folate-replete diet throughout both the pre- and postconception period. These results demonstrate that a low-folate diet that induces NTDs also increases protein homocysteinylation and the subsequent generation of autoantibodies against homocysteinylated proteins. CONCLUSION: These data support the hypotheses that homocysteinylation results in neo-self antigen formation under conditions of maternal folate deficiency, and that this process is reversible with folic acid supplementation.


Subject(s)
Autoantibodies/blood , Blood Proteins/metabolism , Folic Acid Deficiency/complications , Folic Acid/blood , Homocysteine/chemistry , Neural Tube Defects/etiology , Animals , Blood Proteins/immunology , Diet , Dietary Supplements , Disease Models, Animal , Female , Folic Acid/administration & dosage , Folic Acid/immunology , Folic Acid Deficiency/blood , Folic Acid Deficiency/immunology , Folic Acid Deficiency/pathology , Gestational Age , Homocysteine/biosynthesis , Humans , Mice , Mice, Inbred C57BL , Neural Tube Defects/blood , Neural Tube Defects/immunology , Neural Tube Defects/pathology , Pregnancy , Protein Processing, Post-Translational
7.
Med Hypotheses ; 88: 63-7, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26880641

ABSTRACT

Formaldehyde is extremely toxic reacting with proteins to crosslinks peptide chains. Formaldehyde is a metabolic product in many enzymatic reactions and the question of how these enzymes are protected from the formaldehyde that is generated has largely remained unanswered. Early experiments from our laboratory showed that two liver mitochondrial enzymes, dimethylglycine dehydrogenase (DMGDH) and sarcosine dehydrogenase (SDH) catalyze oxidative demethylation reactions (sarcosine is a common name for monomethylglycine). The enzymatic products of these enzymes were the demethylated substrates and formaldehyde, produced from the removed methyl group. Both DMGDH and SDH contain FAD and both have tightly bound tetrahydrofolate (THF), a folate coenzyme. THF binds reversibly with formaldehyde to form 5,10-methylene-THF. At that time we showed that purified DMGDH, with tightly bound THF, reacted with formaldehyde generated during the reaction to form 5,10-methylene-THF. This effectively scavenged the formaldehyde to protect the enzyme. Recently, post-translational modifications on histone tails have been shown to be responsible for epigenetic regulation of gene expression. One of these modifications is methylation of lysine residues. The first enzyme discovered to accomplish demethylation of these modified histones was histone lysine demethylase (LSD1). LSD1 specifically removes methyl groups from di- and mono-methylated lysines at position 4 of histone 3. This enzyme contained tightly bound FAD and the products of the reaction were the demethylated lysine residue and formaldehyde. The mechanism of LSD1 demethylation is analogous to the mechanism previously postulated for DMGDH, i.e. oxidation of the N-methyl bond to the methylene imine followed by hydrolysis to generate formaldehyde. This suggested that THF might also be involved in the LSD1 reaction to scavenge the formaldehyde produced. Our hypotheses are that THF is bound to native LSD1 by analogy to DMGDH and SDH and that the bound THF serves to protect the FAD class of histone demethylases from the destructive effects of formaldehyde generation by formation of 5,10-methylene-THF. We present pilot data showing that decreased folate in livers as a result of dietary folate deficiency is associated with increased levels of methylated lysine 4 of histone 3. This can be a result of decreased LSD1 activity resulting from the decreased folate available to scavenge the formaldehyde produced at the active site caused by the folate deficiency. Because LSD1 can regulate gene expression this suggests that folate may play a more important role than simply serving as a carrier of one-carbon units and be a factor in other diseases associated with low folate.


Subject(s)
DNA Methylation , Folic Acid Deficiency/immunology , Histone Demethylases/chemistry , Histones/chemistry , Catalytic Domain , Epigenesis, Genetic , Escherichia coli/metabolism , Folic Acid/chemistry , Humans , Lysine/chemistry , Mass Spectrometry , Models, Theoretical , Pilot Projects , Protein Processing, Post-Translational , Sarcosine Dehydrogenase/chemistry , Tetrahydrofolates/chemistry
8.
Fish Shellfish Immunol ; 47(1): 289-301, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26381932

ABSTRACT

The aim of this study was to investigate the effect of dietary folic acid on fish growth, the immune and barrier functions of fish gills, and the potential mechanisms of these effects. Young grass carp (Ctenopharyngodon idella) were fed diets containing graded levels of folic acid at 0.10 (basal diet), 0.47, 1.03, 1.48, 1.88 and 3.12 mg kg(-1) diet for 8 weeks. The results showed that acid phosphatase and lysozyme activities and the complement component 3 content in fish gills decreased with folic acid deficiency (P < 0.05). Folic acid deficiency up-regulated liver-expressed antimicrobial peptide 1, interleukin 1ß, interleukin 8, tumor necrosis factor α, nuclear factor κB p65, IκB kinase α (IKK-α), IKK-ß and IKK-γ gene expression. Folic acid deficiency down-regulated interleukin 10, transforming growth factor ß, IκB and target of rapamycin gene expression in fish gills (P < 0.05). These results showed that limited folic acid decreased fish gill immune status. Furthermore, folic acid deficiency down-regulated claudin-b, claudin-c, claudin-3, occludin and zonula occludens 1 gene expression, whereas folic acid deficiency up-regulated claudin-12, claudin-15, myosin light chain kinase and p38 mitogen activated protein kinase gene expression in fish gills (P < 0.05). These results suggested that folic acid deficiency disrupted tight junction-mediated fish gill barrier function. Additionally, folic acid deficiency increased the content of reactive oxygen species, protein carbonyl and malondialdehyde (MDA); Mn superoxide dismutase activity and gene expression; and Kelch-like-ECH-associated protein 1a (Keap1a) and Keap1b gene expression (P < 0.05). Conversely, folic acid deficiency decreased Cu/Zn superoxide dismutase, catalase, glutathione peroxidase, glutathione s-transferases and glutathione reductase activities and gene expression as well as NF-E2-related factor 2 gene expression in fish gills (P < 0.05). All of these results indicated that folic acid deficiency impaired fish gill health status via regulating gene expression of cytokines, tight junction proteins, antioxidant enzymes, NF-κB p65, MLCK and Nrf2. Based on percent weight gain, LZ activity and MDA content in the gills, the dietary folic acid requirements for young grass carp were 1.60, 2.07 and 2.08 mg kg(-1), respectively.


Subject(s)
Carps/immunology , Fish Diseases/genetics , Folic Acid Deficiency/veterinary , Folic Acid/metabolism , Immunity, Innate , Animal Feed/analysis , Animals , Antioxidants/metabolism , Carps/genetics , Diet/veterinary , Dietary Supplements/analysis , Fish Diseases/immunology , Fish Proteins/genetics , Fish Proteins/metabolism , Folic Acid/analysis , Folic Acid Deficiency/genetics , Folic Acid Deficiency/immunology , Gene Expression Regulation , Gills/immunology , Health Status , Myosin-Light-Chain Kinase/genetics , Myosin-Light-Chain Kinase/metabolism , NF-E2-Related Factor 2/genetics , NF-E2-Related Factor 2/metabolism , NF-kappa B/genetics , NF-kappa B/metabolism , Signal Transduction , Tight Junction Proteins/genetics , Tight Junction Proteins/metabolism
9.
Mol Immunol ; 54(2): 164-72, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23280395

ABSTRACT

B-vitamin deficiency is a risk factor for vascular disease. The mechanism by which the deficiency impacts on disease risk is unclear. We have analysed whether the inflammatory response of mononuclear cells can be modified by cellular folate status in vitro. We show that the mouse monocyte cell line RAW264.7 grown under folate restriction displays a decrease in intracellular folate levels and a reduced growth rate. The cells also show a 2- to 3-fold increase in expression of the inflammatory mediators, IL1ß, IL6, TNFα and MCP1 at the RNA and protein level (p<0.01) under conditions of folate deficiency. In contrast the production of the vaso-protective mediator nitric oxide is significantly reduced under these conditions. These metabolic changes are independent of the concentration of homocysteine in the medium and occur in the absence of significant changes in global DNA methylation. Folate deficiency may therefore exacerbate cardiovascular disease by augmenting pro-inflammatory signals in the monocyte-macrophage lineage.


Subject(s)
Folic Acid Deficiency/immunology , Inflammation/immunology , Inflammation/metabolism , Macrophages/immunology , Macrophages/metabolism , Animals , Cell Line , Culture Media/chemistry , Cytokines/genetics , Cytokines/immunology , Cytokines/metabolism , DNA Methylation , Folic Acid/metabolism , Folic Acid Deficiency/genetics , Inflammation/genetics , Inflammation Mediators/immunology , Inflammation Mediators/metabolism , Mice , Nitric Oxide/biosynthesis
10.
Clin Chem Lab Med ; 51(3): 545-54, 2013 Mar 01.
Article in English | MEDLINE | ID: mdl-23314538

ABSTRACT

Folate supplementation reduces the risk of neural tube defect (NTD) pregnancy, and folinic acid has been used to correct cerebral folate deficiency (CFD) in children with developmental disorders. In the absence of systemic folate deficiency, the discovery of autoantibodies (AuAbs) to folate receptor α (FRα) that block the uptake of folate offers one mechanism to explain the response to folate in these disorders. The association of FRα AuAbs with pregnancy-related complications, CFD syndrome, and autism spectrum disorders and response to folate therapy is highly suggestive of the involvement of these AuAbs in the disruption of brain development and function via folate pathways. The two types of antibodies identified in the serum of patients are blocking antibody and binding antibody. The two antibodies can be measured by the specific assays described and exert their pathological effects either by functional blocking of folate transport as previously shown or hypothetically by disrupting the FR by an antigen-antibody-mediated inflammatory response. We have identified both IgG and IgM AuAbs in these conditions. The predominant antibodies in women with NTD pregnancy belong to the IgG1 and IgG2 isotype and in CFD children, the IgG1 and IgG4 isotype. This review describes the methods used to measure these AuAbs, their binding characteristics, affinity, cross-reactivity, and potential mechanisms by which folate therapy could work. Because these AuAbs are associated with various pathologies during fetal and neonatal development, early detection and intervention could prevent or reverse the consequences of exposure to these AuAbs.


Subject(s)
Autoantibodies/blood , Child Development Disorders, Pervasive/diagnosis , Folate Receptor 1/immunology , Folic Acid Deficiency/diagnosis , Neural Tube Defects/diagnosis , Antibodies, Blocking/blood , Antibodies, Blocking/drug effects , Antibody Affinity/drug effects , Autoantibodies/immunology , Child , Child Development Disorders, Pervasive/blood , Child Development Disorders, Pervasive/immunology , Female , Folic Acid/analogs & derivatives , Folic Acid/pharmacology , Folic Acid Deficiency/blood , Folic Acid Deficiency/immunology , Humans , Immunoglobulin G/blood , Immunoglobulin Isotypes/blood , Neural Tube Defects/blood , Neural Tube Defects/immunology , Pregnancy
11.
Epilepsy Behav ; 24(4): 507-12, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22749608

ABSTRACT

Seizure semiology and electroencephalographic (EEG) manifestations of autoimmune-mediated cerebral folate deficiency (CFD) before and after therapy have yet to be fully characterized. Here, we report these findings in two such patients. Our first patient presented with the novel manifestation of infantile spasms at the age of 3months, while the second developed the previously reported initial onset of tonic seizures with static developmental delay, but subsequently manifested the novel finding of electrical status epilepticus in sleep at the age of 15years. Awareness of these new manifestations, together with the previously reported manifestations of developmental delay, seizure onset during the first 2years of life, occurrence of tonic, myoclonic-astatic, absence, and generalized tonic-clonic seizures, with an EEG of generalized spike-slow waves and multifocal spikes, is important to increase the index of suspicion of this treatable disorder.


Subject(s)
Electroencephalography , Folate Receptor 1/immunology , Folic Acid Deficiency/complications , Folic Acid Deficiency/immunology , Seizures/diagnosis , Seizures/etiology , Antibodies/blood , Child , Female , Humans , Male , Seizures/immunology , Young Adult
12.
J Child Neurol ; 23(1): 106-7, 2008 Jan.
Article in English | MEDLINE | ID: mdl-18056694

ABSTRACT

Isolated cerebral folate deficiency was detected in a 13-year-old girl with cognitive and motor difficulties and juvenile rheumatoid arthritis. Her serum contains autoantibodies that block membrane-bound folate receptors that are on the choroid plexus and diminish the uptake of folate into the spinal fluid. Whereas her serum folate exceeded 21 ng/mL, her spinal fluid contained 3.2 ng/mL of 5-methyltetrahydrofolate as a consequence of the autoantibodies diminishing the uptake of this folate.


Subject(s)
Arthritis, Juvenile/complications , Arthritis, Juvenile/physiopathology , Brain Diseases, Metabolic/immunology , Brain Diseases, Metabolic/physiopathology , Folic Acid Deficiency/immunology , Folic Acid Deficiency/physiopathology , Adolescent , Affective Symptoms/immunology , Affective Symptoms/metabolism , Affective Symptoms/physiopathology , Age of Onset , Autoantibodies/blood , Autoantibodies/immunology , Brain/metabolism , Brain/pathology , Brain/physiopathology , Brain Diseases, Metabolic/complications , Carrier Proteins/immunology , Choroid Plexus/immunology , Choroid Plexus/metabolism , Choroid Plexus/physiopathology , Cognition Disorders/immunology , Cognition Disorders/metabolism , Cognition Disorders/physiopathology , Female , Folate Receptors, GPI-Anchored , Folic Acid/metabolism , Folic Acid Deficiency/complications , Humans , Magnetic Resonance Imaging , Motor Skills Disorders/immunology , Motor Skills Disorders/metabolism , Motor Skills Disorders/physiopathology , Receptors, Cell Surface/immunology , Spinal Cord/metabolism , Spinal Cord/pathology , Spinal Cord/physiopathology , Tetrahydrofolates/cerebrospinal fluid
15.
N Engl J Med ; 352(19): 1985-91, 2005 May 12.
Article in English | MEDLINE | ID: mdl-15888699

ABSTRACT

In infantile-onset cerebral folate deficiency, 5-methyltetrahydrofolate (5MTHF) levels in the cerebrospinal fluid are low, but folate levels in the serum and erythrocytes are normal. We examined serum specimens from 28 children with cerebral folate deficiency, 5 of their mothers, 28 age-matched control subjects, and 41 patients with an unrelated neurologic disorder. Serum from 25 of the 28 patients and 0 of 28 control subjects contained high-affinity blocking autoantibodies against membrane-bound folate receptors that are present on the choroid plexus. Oral folinic acid normalized 5MTHF levels in the cerebrospinal fluid and led to clinical improvement. Cerebral folate deficiency is a disorder in which autoantibodies can prevent the transfer of folate from the plasma to the cerebrospinal fluid.


Subject(s)
Autoantibodies/blood , Autoimmune Diseases/diagnosis , Carrier Proteins/immunology , Folic Acid Deficiency/immunology , Folic Acid/metabolism , Receptors, Cell Surface/immunology , Tetrahydrofolates/cerebrospinal fluid , Adolescent , Adult , Biological Transport , Blood-Brain Barrier , Case-Control Studies , Child , Child, Preschool , Choroid Plexus , Female , Folate Receptors, GPI-Anchored , Folic Acid/blood , Folic Acid Deficiency/blood , Folic Acid Deficiency/cerebrospinal fluid , Humans , Male
16.
J Nutr ; 132(6): 1361-7, 2002 Jun.
Article in English | MEDLINE | ID: mdl-12042459

ABSTRACT

Dietary folate deficiency enhances, whereas folate supplementation suppresses, the development of several cancers. This study investigated the effect of folate deficiency on natural killer cell (NK)-mediated cytotoxicity, which is important in immune surveillance against tumor cells. In Experiment 1, severe folate deficiency was induced in rats by feeding an amino acid-defined diet containing 0 mg folate and 10 g succinylsulfathiazole/kg diet. Control and folate-supplemented rats were fed the same diet containing 2 (basal requirement) and 8 mg folate/kg diet, respectively. Severe folate deficiency at the end of wk 5 was associated with 20% growth retardation, a 60% reduction in lymphocyte counts and significantly impaired NK-mediated cytotoxicity compared with the control and folate-supplemented groups (P < 0.02). The lesser degree of severe folate deficiency achieved by wk 4 was not associated with impaired NK-mediated cytotoxicity. Folate supplementation at 4x the basal requirement did not significantly enhance NK-mediated cytotoxicity at either time point. In Experiment 2, moderate folate deficiency was induced in rats by feeding the same diet without succinylsulfathiazole. NK-mediated cytotoxicity in the moderately folate-deficient rats (without growth retardation or lymphopenia) was not significantly different from that in controls. Although severe folate deficiency may have adverse effects on NK-mediated cytotoxicity, moderate folate deficiency, a degree of depletion associated with an increased risk of several cancers, appears not to affect NK-mediated cytotoxicity in rats. Furthermore, a modest level of folate supplementation above the basal requirement does not enhance NK-mediated cytotoxicity. These data collectively suggest that NK-mediated cytotoxicity is not a likely mechanism by which folate status modulates carcinogenesis.


Subject(s)
Cytotoxicity, Immunologic , Folic Acid Deficiency/immunology , Folic Acid/metabolism , Killer Cells, Natural/immunology , Neoplasms/immunology , Adjuvants, Immunologic , Animals , Folic Acid/administration & dosage , Folic Acid Deficiency/metabolism , Folic Acid Deficiency/physiopathology , Homocysteine/blood , Liver/metabolism , Lymphocyte Subsets/immunology , Male , Neoplasms/etiology , Rats , Rats, Sprague-Dawley
18.
Prog Food Nutr Sci ; 15(1-2): 43-60, 1991.
Article in English | MEDLINE | ID: mdl-1887065

ABSTRACT

Folic acid plays a crucial role in DNA and protein synthesis, suggesting that every mechanism in which cell proliferation intervenes may be altered. Cell-mediated immunity is especially affected by folate deficiency: the blastogenic response of T lymphocytes to certain mitogens is decreased in folate-deficient humans and animals, and the thymus is preferentially altered. The effects of folic acid deficiency upon humoral immunity have been more thoroughly investigated in animals than in humans, and the antibody responses to several antigens have been shown to decrease. Conversely, the phagocytic and bactericidal capacities of polymorphonuclear cells have been studied mainly in folate-deficient humans. However results in this field are controversial. Alterations in immune system functions could lead to decreased resistance to infections, as commonly observed in folate-deficient humans and animals.


Subject(s)
Folic Acid Deficiency/immunology , Folic Acid/physiology , Animals , Antibody Formation , DNA/biosynthesis , DNA/drug effects , Folic Acid/pharmacology , Humans , Immunity, Cellular , Neutrophils/immunology , Phagocytosis , Protein Biosynthesis , Proteins/drug effects
19.
Clin Exp Immunol ; 83(1): 121-5, 1991 Jan.
Article in English | MEDLINE | ID: mdl-1824831

ABSTRACT

Marrow aspirates from 11 patients with megaloblastic haemopoiesis and from 14 healthy individuals with normoblastic haemopoiesis were studied for antibodies associated with polychromatic/orthochromatic erythroblasts, using an 125I-labelled anti-human immunoglobulin reagent and autoradiography. In addition, the expression on these cells of receptors for FcIgG (FcR) and of the type I receptor for fragments of the third complement component (CR1) were investigated with receptor-specific monoclonal antibodies, 125I-labelled anti-mouse immunoglobulin and autoradiography. The percentages of immunoglobulin-positive erythroblasts were significantly greater in the megaloblastic than in the normoblastic marrows. Abnormally high percentages of labelled erythroblasts were present in patients without any manifestations of an autoimmune disorder. The percentage of labelled erythroblasts in the marrows of the patients correlated well with the degree of anaemia. FcR were absent on the majority of megaloblasts or normoblasts while the expression of CR1 was similar in both types of cell. The difference between the percentage labelling of megaloblasts and normoblasts was therefore unlikely to be due to greater binding of immune complexes with or without associated complement to megaloblasts than normoblasts. The megaloblast-bound immunoglobulin is, therefore, likely to have recognized abnormally expressed epitopes on the surface of megaloblasts. The results suggest that natural autoantibodies play a role in the destruction of erythroblasts during megaloblastic haemopoiesis.


Subject(s)
Autoantibodies/immunology , Erythropoiesis/immunology , Megaloblasts/immunology , Antibodies, Monoclonal/immunology , Autoantibodies/physiology , Autoradiography , Bone Marrow/physiopathology , Erythrocytes/immunology , Female , Folic Acid Deficiency/immunology , Folic Acid Deficiency/physiopathology , Humans , Immunoglobulin G/metabolism , Male , Receptors, Complement/metabolism , Receptors, Complement 3b , Receptors, Fc/metabolism , Vitamin B 12 Deficiency/immunology , Vitamin B 12 Deficiency/physiopathology
20.
Article in English | MEDLINE | ID: mdl-1673889

ABSTRACT

1. Three groups of weanling C57BL/6 female mice were fed one of two folate-deficient diets (0 and 0.1 mg folic acid/kg diet) or a normal folate-containing diet (2 mg folic acid/kg diet) for 8 weeks. A control pair-fed group was introduced with the most severe folate-deficient diet. Seven mice were fed the 0 mg folic acid/kg diet for 8 weeks, then rehabilitated (R) on the 2 mg folic acid/kg diet for 10 days. 2. Mice fed 0 mg folic acid/kg diet were severely folate-deficient (SFD), whereas mice fed 0.1 mg folic acid/kg diet were moderately folate-deficient (MFD), as shown by their folate status parameters. 3. Thymus weight, thymocyte content and positive immature CD4+8+ cells were decreased in SFD mice compared to controls. These values were normalized after 10 days of rehabilitation. 4. Mesenteric lymph node cells were apparently not affected by folate deficiency. 5. The proportion of Thy-1+ splenocytes was mildly lower in SFD mice than in controls. In R mice, mean spleen weight and spleen cellularity were increased compared to the other groups, but the proportions of Thy-1+, CD4+8- and CD4-8+ cells were markedly lower than control values.


Subject(s)
Folic Acid Deficiency/immunology , Lymphocyte Subsets/immunology , Lymphoid Tissue/immunology , Animals , Body Weight/immunology , Female , Lymph Nodes/immunology , Lymphoid Tissue/cytology , Mice , Mice, Inbred C57BL , Spleen/immunology , Thymus Gland/immunology
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