Role of Vitamin K in Intestinal Health.

Intestinal diseases, such as inflammatory bowel diseases (IBDs) and colorectal cancer (CRC) generally characterized by clinical symptoms, including malabsorption, intestinal dysfunction, injury, and microbiome imbalance, as well as certain secondary intestinal disease complications, continue to be serious public health problems worldwide. The role of vitamin K (VK) on intestinal health has drawn growing interest in recent years. In addition to its role in blood coagulation and bone health, several investigations continue to explore the role of VK as an emerging novel biological compound with the potential function of improving intestinal health. This study aims to present a thorough review on the bacterial sources, intestinal absorption, uptake of VK, and VK deficiency in patients with intestinal diseases, with emphasis on the effect of VK supplementation on immunity, anti-inflammation, intestinal microbes and its metabolites, antioxidation, and coagulation, and promoting epithelial development. Besides, VK-dependent proteins (VKDPs) are another crucial mechanism for VK to exert a gastroprotection role for their functions of anti-inflammation, immunomodulation, and anti-tumorigenesis. In summary, published studies preliminarily show that VK presents a beneficial effect on intestinal health and may be used as a therapeutic drug to prevent/treat intestinal diseases, but the specific mechanism of VK in intestinal health has yet to be elucidated.

Effects of specific nutrients on the immune response. Selected clinical applications.

The importance of diet in multiple aspects of the immune response is inescapable. Although only a few trials have attempted to apply knowledge derived from in-vitro and animal data to humans, the ability to modulate or "reset" the immune response by manipulating dietary intake will surely continue to be studied in the future. The role of various nutrients in immunity is reviewed and clinical applications are noted.

The inhibitor of prothrombin conversion in plasma of patients on oral anticoagulant treatment.

Pooled plasma of patients under stable oral anticoagulation has been analysed with respect to the presence of the vitamin-K dependent factors (factors II, VII, IX and X). Of all factors 1.5-2 times more antigen than procoagulant activity was present. The concentration of factors II, X (measured spectrophotometrically) and VI is about 0.25 U/ml while factor IX is slightly higher. Coagulation assays of factor X always gave lower values than the spectrophotometric assay. This discrepancy was not influenced by the removal of either factor II-, factor VII- or factor IX antigen. However, when the factor X antigen was replaced by normal factor X, all factor X assay gave identical results, indicating that PIVKA X is responsible for these discrepancies. Using the technic of the Thrombotest-dilution curve it was shown that PIVKA X is the factor that causes the abnormal prolongation of ox-brain prothrombin time in these plasmas.

The sensitizing capacity of naturally occurring quinones. Experimental studies in guinea pigs. I. Naphthoquinones and related compounds.

Experimental studies on the sensitization capacity of naturally occurring naphthoquinones derived from plants and woods have been carried out with 6 compounds. With 4 of these substances (desoxylapachol, menadione, lapachenole andmacassar quinone) guinea pigs could be sensitized. Desoxylapachol, sensitizer from teak wood, and lapachenole, sensitizer from perobawood proved to be the most effective ones. Experiments with macassar quinone (oxidation product of a naphthalene constituent of macassar ebony) still demonstrate that even ortho-naphthoquinones are capable to induce contact allergy. Allergic cross reactions could be obtained with 9 out of 14 different napthoquinones. In animals sensitized with desoxylapachol menadione and lapachol showed the strongest eliciting effect. Furthermore the study demonstrated that the sensitizing effect of naphthoquinones depends on the length and position of the side chain attached to the quinoid ring as well as on the substitution of the carbon atom adjacent to the side chain bearing C-atom. With compounds substituted at this C-atom (e.g. position 3 of lapachol or didimethylallylnaphthoquinone) sensitization could not be obtained.

Cross-reactions between 2, 4-dinitrophenyl and menadione (vitamin K3) and the general problem of antibody specificity.

Early and late antisera to 2, 4-dinitrophenyl (DNP) and to menadione (K3)4 were compared for reactivity with diverse DNP and K3 ligands. Late antisera were generally more reactive (higher affinity) than early antibodies. Nevertheless, the early antibodies had higher affinity for homologous ligands than late antibodies had for heterologous ligands; the exception, a small (ca. 5%) and possibly heteroclitic subset from late anti-DNP sera, had higher affinity for K3-butyrate than for DNP-lysine. Early antisera appeared to be more specific than late antisera by one criterion (the precipitin reaction), but less specific by a more fundamental criterion (KO/KX, the ratio of intrinsic affinities for homologous and cross-reacting ligands). By several methods (precipitation, binding to heterologous immunoadsorbants) 25 to 75% of the antibodies in both anti-DNP and anti-K3 sera were cross-reactive; even more cross-reactivity was evident by equilibrium dialysis, where it appeared that virtually all anti-DNP antibodies can bind K3 and that virtually all anti-K3 can bind DNP. This extreme level of cross-reaction is not as "strange" as was once thought, it seems unwarranted to regard this cross-reaction as support for the view that antibodies in general are multispecific.

The strange cross-reaction of menadione (vitamin K3) and 2,4-dinitrophenyl ligands with a myeloma protein and some conventional antibodies.

To explore the possibility that the affinity of some myeloma proteins for 2,4-dinitrophenyl (DNP) ligands is the consequence of a "strange" (i.e., unexpected) cross-reaction for more natural ligands, a variety of substances (primarily derivatives of purines, pyrimidines, naphthaquinone) were tested for ability to block the binding of [(3)H]-epsilon-DNP-L-lysine by protein 315, an IgA mouse myeloma protein with high affinity for DNP ligands. The most impressive inhibiting activity was observed with 2-methyl-1,4-napthaquinone (menadione, vitamin K(3)). The affinity (intrinsic association constant) of protein 315 for menadione was 5 x 10(5) L/M (at 4 degrees C). Because the same affinity was measured in direct-binding assays (e.g., equilibrium dialysis) and in an indirect one based on the assumption of competitive binding with DNP-lysine, it is likely that menadione and DNP bind at overlapping sites in the protein's combining region. This conclusion is supported by molecular models which reveal some common structural features in these ligands. Hence it is not surprising that antinitrophenyl antibody preparations, raised by conventional immunization procedures (anti-2,4-DNP; anti-2,6-DNP; anti-2,4,6-TNP) also bind menadione with considerable affinity. As with DNP ligands, when menadione binds to protein 315 or to conventional antinitrophenyl antibodies, some of the protein's tryptophan fluorescence is quenched, there is a change in the ligand's absorption spectrum (hypochromia and/or red shift), and the binding is temperature-dependent (exothermal).