Vitamin B12: Part 1 – Flashcards
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Pernicious (fatal) Anemia |
- B12 deficiency due to lack of intrinsic factor
- Lead to irreversible neurological degeneration of nervous system |
Cobalamin Forms: 1. --CN 2. --OH 3. --NO2 4. --H2O 5. --5'-deoxyadenosyl 6. --CH3 |
- Which group is attached to cobalt determines which form B12 is in:
1. --CN: cyanocobalamin (most stable synthetic form) 2. --OH: hydroxycobalamin: synthetic 3. --NO2: nitritocobalamin 4. --H2O: aquocobalamin 5. --5'-deoxyadenosyl (used in body) 6. --CH3: methylcobalamin (used in body) |
Vitamin B12 Absorption: Active
(1) Diet
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- Naturally occurring B12 in food is bound to protein
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Vitamin B12 Absorption: Active
(2) Stomach |
? = HCl + Pepsin
- HCl denatures the protein & then activates pepsin to act on peptide bonds to breakdown the protein, releasing B12 from food
- B12 binds to R pros (salivary or from gastric juices)
- IF prod by parietal cells
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Vitamin B12 Absorption: Active
(3) SI: Duodenum |
- B12 released from R pros
- R pros hydrolyzed by pancreatic proteases
- B12 binds IF = B12-IF complex (resistant to pancreatic enzymes) - B12-IF traverses SI (duodenum --> ileum) and binds to specific receptors on brush border of ileal mucosa |
Vitamin B12 Absorption: Active
(4) Enterocyte (ileum) |
- Enterocyte: intestinal absorptive cells
- B12-IF absorbed intact via receptor-mediated endocytosis, which requires:
- B12-IF now a lysozome ---> brkdwn IF to release B12 (now free to enter portal circulation) |
Vitamin B12 Absorption: Passive Diffusion |
- occurs when large doses consumed (remaining B12 that can't proceed via active absorption)
- location: throughout GI, oral/nasal mucous membranes
- rapid process BUT inefficient |
Vitamin B12: Enterohepatic Circulation |
- Enterohepatic circulation: circulation of biliary acids from the liver, where they are produced and secreted in the bile then move to the SI
- B12 secreted into bile: can bind to IF in SI and be reabsorbed in ileum |
Vitamin B12: Transport |
- Prior to transport across membrane of ileal cells, B12 binds transcobalamin to deliver B12 to cell receptor
- Holo-TC (bound to B12) complex taken up by cells
- Haptocorrin (HC): tissues don't take up this form
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Cellular Uptake |
- Most tissues contain: holotoranscobalamin receptors (Holo-TC) = evidence that TC is primary B12 delivery pro
- B12-holoTC taken into cells via endocytosis & then fused w/ (enter) acidic lysosomes
- TC degraded, B12 released |
Storage & Excretion |
- 2-3 mg (large) stored in body-> primarily in liver
- Reabsorption from bile essential
- Excretion:
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B12 Pathway: Remethylation of homocysteine |
- occur in cytoplasm; 2 parts
1. 5-methyl-THF + cobalamin(I)--MS--> THF + methylcobalamin (+3 form)
2. methylcobalamin (+3) + homocysteine --MS--> cobalamin(1) + Met
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B12 as Reactive Species |
- Every 200-2000 turnovers (in Hcy->Met), B12 undergoes oxidation
- cobalamin(II) --MS reductase--> cobalamin(I)
- needs to be cobalamin(I) to be converted back to cobalamin(III) = active form |
Folate Methyl Trap & B12 deficiency |
- Formation of 5-methyl-THF is irreversible
- B12 needed to convert 5-methyl-THF to THF
- B12 deficiency = can't regenerate THF which is needed to for 5,10methyleneTHF for DNA synthesis
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Masking B12 deficiency |
- Macrocytic anemia (^MCV, low #RBC, Hb) occurs w/ B12 and folate deficiency
- Assume folate def & treat w/ folic acid = reverse anemia
- BUT: if actually B12 deficiency, neuropathy will still result causing spinal degeneration |
B12 Pathway: L-methylmalonyl-CoA ---> succinyl CoA |
- occurs in mitochondria - L-methylmalonyl CoA--> succinyl CoA
- enz: methylmalonyl CoA mutase
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B12 Deficiency: Effect on M-CoA-Reductase |
- methylmalonyl CoA reductase impaired causing: - methylmalonyl CoA ---> methylmalonic acid (MMA)
- ^MMA = useful dx for B12 def
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