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In the scope of vegetarian diets, cobalamin (CBL or vitamin B12) remains a particular concern, as it is mostly absent from natural, vegetarian foods. As such, vegetarians must rely on supplementation or enriched food products, to fulfil their recommended daily intake of the vitamin. The potential of microalgae is of extreme importance in this context, given the fact that they may absorb exogenous CBL and display significant levels of the vitamin. Therefore, it is crucial to establish fast and reliable B12 determination methods, to accurately characterize these products or ingredients and conclude about their role as CBL sources. To that extent, this work presents the application of the AOAC's final action method 2014.02 on the determination of total CBL in selected, commercial, microalgae and cyanobacteria powder samples. Four variants of Chlorella vulgaris, namely organic, smooth, white and honey, as well as Spirulina (Arthrospira platensis) were investigated. High-performance liquid chromatography coupled with ultraviolet (UV), diode-array detection (HPLC-DAD) was implemented in the analysis of microalgal extracts. After slight adaptation and optimisation of the extraction and analysis procedures, namely to allow lower sample amounts, it was determined that the different commercial Chlorella products, organic, smooth, white and honey have total CBL concentrations of 1063 ± 158 μg (100 g)-1, 482 ± 55 μg (100 g)-1, 681 ± 87 μg (100 g)-1 and 660 ± 68 μg (100 g)-1, respectively. Analysis of Spirulina did not yield any measurable levels of CBL in any of the purified extracts. Despite the obtained results displaying the same order of magnitude previously determined in similar microalgal products, these CBL values are amongst the highest concentrations found. Therefore, even considering the known limitations in bioaccessibility and bioavailability of CBL in microalgae, it is possible to conclude that these results stand for the inclusion of these products in vegetarian foods or as food supplements, as good potential sources of CBL, which is generally lacking in vegetarian diets. [ABSTRACT FROM AUTHOR]

Inflammatory bowel diseases (IBDs) are immune chronic diseases characterized by recurrent episodes, resulting in continuous intestinal barrier damage and intestinal microbiota dysbiosis. Safe strategies aimed at stabilizing and reducing IBDs recurrence have been vigorously pursued. Here, we constructed a recurrent intestinal injury Drosophila model and found that vitamin B12 (VB12), an essential co-factor for organism physiological functions, could effectively protect the intestine and reduce dextran sulfate sodium-induced intestinal barrier disruption. VB12 also alleviated microbial dysbiosis in the Drosophila model and inhibited the growth of gram-negative bacteria. We demonstrated that VB12 could mitigate intestinal damage by activating the hypoxia-inducible factor-1 signaling pathway in injured conditions, which was achieved by regulating the intestinal oxidation. In addition, we also validated the protective effect of VB12 in a murine acute colitis model. In summary, we offer new insights and implications for the potential supportive role of VB12 in the management of recurrent IBDs flare-ups. [ABSTRACT FROM AUTHOR]

Background: Drug duplication (DD), the use of two identical drugs simultaneously, is a medication error increasing the risk of adverse drug events. We describe the trends and implicated drugs in potential DD in older adults in Sweden from 2006 to 2021. Methods: We conducted a register-based, repeated cross-sectional study of all older adults (aged ≥65 years) dispensed drugs at a community pharmacy in 2006–2021. DD was defined as a ≥30-day overlap of two dispensations of drugs with the same 5th level (chemical substance) Anatomical Therapeutic Chemical (ATC) classification, but with different brand names, within a 3-month period each year. Results: Among Swedish older adults with ordinary prescriptions (i.e. multidose excluded; n ≈ 1,200,000–1,600,000 per year), the prevalence of potential DD increased from 5.2% to 10.6% in 65- to 79-year-olds and from 7.0% to 11.7% in those aged ≥80 years. The drug groups (ATC level 3; pharmacological subgroup) most frequently implicated in DD in 2006 were β-blocking agents, angiotensin-converting enzyme (ACE) inhibitors, and calcium channel blockers, and in 2021 Vitamin B12 and folic acid, β-blocking agents and angiotensin II receptor blockers. Conclusions: DD represents a common but unnecessary and potentially hazardous medication error. Our results indicate that during the last two decades, the prevalence has almost doubled in older adults with ordinary prescriptions, reaching 11% in 2021. More national efforts are needed to revert this trend, including a nationally available complete drug list for all patients, and prescriber support to detect DD. [ABSTRACT FROM AUTHOR]

Background: Pregnant and postpartum women are at high risk of depression due to hormonal and biological changes. Antenatal depression is understudied compared to postpartum depression and its predictors remain highly controversial. Aim: To estimate the prevalence of depressive symptoms during pregnancy and investigate factors associated with this condition including vitamin D, folate and Vitamin B12 among participants in the Kuwait Birth Study. Methods: Data collection occurred as part of the Kuwait Birth Cohort Study in which pregnant women were recruited in the second and third trimester during antenatal care visits. Data on antenatal depression were collected using the Edinburgh Postnatal Depression Scale (EPDS), considering a score of ≥ 13 as an indicator of depression. Logistic regression was used to investigate factors associated with depressive symptoms in pregnant women. Results: Of 1108 participants in the Kuwait Birth Cohort study, 1070(96.6%) completed the EPDS. The prevalence of depressive symptoms was 21.03%(95%CI:18.62–23.59%) and 17.85%(95%CI:15.60-20.28%) as indicated by an EPDS ≥ 13 and EPDS ≥ 14 respectively. In the multivariable analysis, passive smoking at home, experiencing stressful life events during pregnancy, and a lower level of vitamin B12 were identified as predisposing factors. Conversely, having desire for the pregnancy and consumption of fruits and vegetables were inversely associated with depressive symptoms. Conclusion: Approximately, one fifth of pregnant women had depressive symptoms indicating the need to implement screening program for depression in pregnant women, a measure not systematically implemented in Kuwait. Specifically, screening efforts should focus on pregnant women with unintended pregnancies, exposure to passive smoking at home, and recent stressful live events. [ABSTRACT FROM AUTHOR]

Hyperhomocysteinemia or high levels (> 15 µmol/L) of homocysteine (Hcy)in the blood has been suggested to affect the brain through vascular and neurodegenerative pathways and potentially impact cognition. The current study aims to explore the association of high homocysteine with cognition and brain volume changes in a cohort of middle and old agedr adults. The study recruited 1296 participants aged ≥ 45 years from Tata Longitudinal Study of Ageing (TLSA), an ongoing cohort study. The participants underwent detailed cognitive assessments using Addenbrooke's Cognitive Examination-III (ACE-III) and Computerized Assessment of Adult Information Processing (COGNITO) neuropsychological battery and MR imaging using a 3T scanner. The participants were classified based on the median homocysteine level (16.89 µmol/L) into low Hcy (≤ median) and high Hcy (> median) groups. When adjusted for age, gender, years of education, vitamin B12, folate and dyslipidaemia, Generalised Linear Model (GLM) found a significant association of high Hcy with vocabulary task [β (95% CI) − 1.354 (− 2.655, − 0.052); p = 0.041]. Significant associations was also obtained between cerebral white matter volume and high Hcy [β (95% CI) − 5617.182 (− 11062.762, − 173.602); p = 0.043]. The results suggest that people with high Hcy levels performed poorer in cognitive tasks related to language domain and had lesser cerebral white matter volume. This indicates that homocysteine might have a profound impact on brain structure as well as function. [ABSTRACT FROM AUTHOR]

Anemia is a common but often underdiagnosed and undertreated geriatric syndrome in hospitalized older patients. In this retrospective multicenter study, we aimed at characterizing the prevalence, risk factors, diagnostic and treatment approach to anemia in older patients admitted to acute care hospitals, focusing on differences between nephrology and geriatrics units. Prevalence and risk factors for anemia, diagnostic inertia (lack of iron, vitamin B12, and folate status assessment), replacement inertia (omitted treatment with iron, vitamin B12 or folic acid), and erythropoiesis-stimulating agents (ESA) inertia were explored. 1963 patients aged 82.7 (6.8) years were included in the study; 66.7% of the study population had anemia; among anemic patients, diagnostic inertia and replacement inertia were common with rates of 22–31% and 50–87%, respectively; omitted treatment with ESA affected 67.2% of patients and was more prevalent in geriatric units. In most cases, patients with ESA inertia were not routinely screened for iron tests. COPD, cancer, eGFR 45–60 ml/min were associated with increased tendency to ESA inertia. In conclusion, anemia had a high prevalence in older patients discharged from acute care units, but it is often underdiagnosed and undertreated. [ABSTRACT FROM AUTHOR]

Purpose: This updated umbrella review aimed to evaluate the evidence regarding the associations between dietary factors and the risks of esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC). Methods: The PubMed, Embase, Cochrane Library, and Web of Science databases were searched to identify relevant studies. The quality of the included meta-analyses was evaluated using A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2). For each association, the number of cases, random effects pooled effect size, 95% confidence intervals (CIs), heterogeneity, 95% prediction interval (PrI), small-study effect, and excess significance bias were recalculated to determine the evidence level. Results: We identified 33 meta-analyses describing 58 dietary factors associated with ESCC and 29 meta-analyses describing 38 dietary factors associated with EAC. There was convincing evidence regarding the association of 2 dietary factors (areca nut and high alcohol) with the risk of ESCC. There was highly suggestive evidence regarding the association of only 1 dietary factor (healthy pattern) with the risk of ESCC. There was suggestive evidence regarding the association of 11 dietary factors with the risk of ESCC, including fruit, citrus fruit, vegetables, pickled vegetables, maté tea, moderate alcohol, hot beverages and foods, hot tea, salt, folate, and vitamin B6. There was convincing evidence regarding the association of one dietary factor (vitamin B6) with the risk of EAC. There was suggestive evidence regarding the association of 4 dietary factors with the risk of EAC, including processed meat, dietary fibre, carbohydrate, and vitamin B12. The convincing evidence regarding the associations between dietary factors and the risks of ESCC and EAC remained robust in sensitivity analyses. Conclusions: This umbrella review highlighted convincing evidence regarding the associations of areca nut and high alcohol with a higher risk of ESCC. Additionally, an association between vitamin B6 and a decreased risk of EAC was observed. Further research is needed to examine the dietary factors with weak evidence regarding their associations with ESCC and EAC. [ABSTRACT FROM AUTHOR]

Purpose: With dairy products and fish being major sources of iodine in Switzerland, the growing popularity of plant-based alternatives may impact iodine nutrition. This study aimed to assess the iodine content in plant-based dairy and fish alternatives available in the Swiss market and compare them with conventional products. Methods: In 2022, a market survey was conducted in Zurich, Switzerland, to identify the plant-based dairy and fish alternatives available and assess their iodine content. To evaluate the impact of plant-based alternatives on iodine consumption in Switzerland, we modeled dietary scenarios by substituting the intake of dairy and fish items with plant-based alternatives. In addition, we investigated fortification with calcium, vitamins B2, B12, and D. Results: Out of 477 identified products, only four milk-alternative products were iodine fortified (median iodine concentration: 22.5 μg/100 ml). The median iodine concentration in unfortified plant-based alternatives was negligible compared to conventional dairy and fish products (milk: 0.21 vs 9.5 μg/100 ml; yogurt 0.36 vs 6.1 μg/100 g; cheese: 0.10 vs 20 μg/100 g; fish 0.50 vs 44 μg/100 g). Three portions of dairy per day as recommended by the Swiss Food Pyramid provide 25% of the RDA for iodine (150 μg/day), whereas substituting those with unfortified alternatives provides only 0.7% of the RDA. Conclusion: Only four out of 477 plant-based alternative products are iodine fortified in the Swiss market. Thus, the risk for consumers to miss out on the ca. 25% of the RDA for iodine by consuming plant-based alternatives is high, placing them at a risk for inadequate iodine intake. [ABSTRACT FROM AUTHOR]

Purpose: Epidemiological studies examining the association between circulating micronutrients and the risk of hypertensive disorders during pregnancy (HDP) have produced inconsistent results. Therefore, we conducted a Mendelian randomization (MR) analysis to evaluate the potential causal relationship between micronutrients and HDP. Methods: Nine micronutrients (beta-carotene, vitamin B6, vitamin B12, calcium, zinc, selenium, copper, folate, and phosphorus) were selected as the exposure factors. Summary data for gestational hypertension (14,727 cases and 196,143 controls) and preeclampsia/eclampsia (7212 cases and 174,266 controls) were extracted from the FinnGen consortium. The MR analysis employed the inverse variance weighted method and conducted a range of sensitivity analyses. Results: The inverse variance weighted method indicated no significant causal relationship between nine genetically predicted micronutrient concentrations and gestational hypertension, as well as preeclampsia/eclampsia. Sensitivity analyses suggested the absence of pleiotropy. Conclusion: There is no strong evidence to support the causation between circulating micronutrients and hypertensive disorder during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Vitamin B12 is primarily transported from plasma to cells by Transcobalamin. Deficiency of Transcobalamin is a rare autosomal recessive disorder that results in unavailability of cobalamin in cells and accumulation of homocysteine and methylmalonic acid. Case Report: We report a case of a 2-year-old male child with persistent pancytopenia, recurrent infections, and megaloblastic anemia. Next-generation sequencing identified a novel variant in exon 8 of TCN2 gene. Substantial improvement has been observed following administration of high doses of parenteral methylcobalamin. Conclusion: In patients with unresolved pancytopenia and megaloblastic anemia, Transcobalamin deficiency should be investigated and treated promptly to prevent any irreversible and harmful outcome. [ABSTRACT FROM AUTHOR]

Background: Malnutrition poses a significant global health challenge, affecting various age groups, with infants under 6 months being particularly vulnerable. Vitamin B12, an essential micronutrient critical for neurological development, has been identified as a key player in the overall health of both mothers and infants. Aim: To find the correlation between serum vitamin B12 levels in infants, 1–6 months of age with severe malnutrition and maternal levels at tertiary care hospitals in western Rajasthan. Methods: The cross-sectional study was conducted in the UNICEF Regional Center of Excellence-supported Nutrition Rehabilitation Center in Rajasthan, India, through simple random sampling. One hundred ten infants with their mothers were enrolled after consent and approval from the Institutional Ethics Committee. Results: Severe malnutrition predominantly affected infants aged 1–2 months, with 77% born small for gestational age and 66.4% belonging to the multiple birth order group. Serum vitamin B12 levels showed a significant positive correlation between mothers and infants (p < 0.001), while exclusive breastfeeding correlated positively with age-appropriate milestones (p = 0.033). Conclusion: The findings emphasize the importance of targeted interventions addressing maternal and infant nutrition, with a focus on ensuring adequate vitamin B12 levels. [ABSTRACT FROM AUTHOR]

This study identified vitamin B12 compounds in traditional fermented Japanese seafoods, such as heshiko made with a mackerel, kusaya made with a flying fish, Akazukuri-shiokara made with a squid, and funazushi made with a crucian carp, using reversed-phase high-performance liquid chromatography and liquid chromatograph–tandem mass spectrometry. The vitamin B12 content of these fermented seafoods was approximately 4–13 µg/100 g wet weight, indicating that vitamin B12 is the predominant corrinoid in all seafoods tested. However, kusaya contained approximately 8% of inactive cobamides such as 2-methyladenylcobamide and 2-methylmercaptoadenylcobamide. In conclusion, these traditional fermented Japanese seafoods can be a source of vitamin B12. [ABSTRACT FROM AUTHOR]

Cobalamin (Vitamin B12) is a cofactor for many enzymes, including those in bacteria, archaea, algae, and mammals. In humans, cobalamin deficiency can lead to pernicious anaemia as well as gastrointestinal and neurological disorders. In contrast to marine ecosystems, there is a great paucity of information on the role of soils and terrestrial plants in the supply of cobalt and cobalamin to microorganisms and animals. The content of cobalt cations in most soils is usually sufficient to maintain growth, and the density of cobalamin-producing soil prokaryotes is high in comparison to water bodies. The cobalt content of most soils is usually sufficient in comparison with water, and the density of cobalamin-producing soil prokaryotes is high. Therefore, terrestrial plants are an important cobalt source for cobalamin-producing rumen and gut prokaryotes. The major source of cobalamin for most other animals is the meat of ruminants as well as other animal-derived products, bacteria in insects, and coprophagy, e.g., by rodents. In addition, faecal deposits, and fertilizers as well as soil bacteria add to the cobalamin supply. However, those archaea and bacteria that do not produce cobalamin obtain this coenzyme or its analogues from the environment. Therefore, presence or absence of cobalamin-producing species in soil affects the whole soil microbiome. However, our knowledge concerning microbial producers and consumers of cobalamin in soils is still limited, despite some recent advances. The main reasons are a low cobalamin content in soils and challenging methods of determination. In this regard, advanced analytical knowledge and technical equipment are required, which are usually unavailable in soil laboratories. This review provides relevant methodological information on sample homogenization, extraction, concentration, and purification as well as analysis of cobalamin. [ABSTRACT FROM AUTHOR]

The aim of our study is to develop a simple, delicate, precise and economical protocol for the qualitative and quantitative determination of Chlorpheniramine using spectrophotometer. Our validation is distinctive and provides a precise picture of a very weak chromophore of chlorpheniramine (CPN) that had not been accurately detected before by traditional techniques. The blue color which formed by mixing pheniramine and Cobalt- thiocyanate solution was extracted with chloroform. CPN presented a linearity range of 25 – 125 μg at 628 nm. Limit of quantification (15 μg/mL) and limit of detection (08 μg/mL) of cobalt-chloride were analyzed. The resulting data was statistically significant. Because of the appropriate reproducibility and reliability of this proposed analysis, it can be used to screen CPN in pharmaceutical preparations. It is also validated through the International Council of Harmonization for accuracy, linearity, precision, LOD and LOQ. Various dosage forms of pheniramine were evaluated and have shown that they did not exceed their relative standard deviation by 1%. Their percentage purity was within 99.62 – 103.34%. The suspected sample was treated with 2 – 3 drops of cyanocobalamine after which violet coloration appeared. The percentage relative standard deviation of accuracy and precision was acquired as 1.57 and 1.15, respectively, exactly following the authentication criteria for newly established methods. Because of the profound potential of these developed methods, including precise, fast, flawless and inexpensive, it can easily be adopted in laboratories for the routine analysis of Chlorpheniramine. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal disorders are an important cause of work absence. Clinical practice guidelines recommend nonsteroidal anti-inflammatory drugs (NSAIDs) for grade I–II cervical sprains. The combination of thiamine + pyridoxine + cyanocobalamin vitamins has been used, alone and in combination with NSAIDs, for pain and inflammation in musculoskeletal disorders. Objective: The objective of this study was to demonstrate the analgesic synergy of dexketoprofen, and the combination of vitamins thiamine + pyridoxine + cyanocobalamin in a fixed-dose combination (FDC) for the treatment of acute pain caused by grade I–II cervical sprains. Methods: We conducted a multicentre, prospective, randomized, double-blind, phase IIIb clinical study comparing two treatment groups: (1) dexketoprofen 25 mg/vitamin B (thiamine 100 mg, pyridoxine 50 mg and cyanocobalamin 0.50 mg) in an FDC (two or more active ingredients combined in a single dosage form) versus (2) dexketoprofen 25 mg monotherapy (single drug to treat a particular disease), one capsule or tablet orally, every 8 h for 7 days. Final mean, average change, and percentage change in pain perception (measured using a visual analogue scale [VAS]) were compared with baseline between groups. A p value < 0.05 was considered statistically significant. Analyses were conducted using SPSS software, v.29.0. Results: A statistically significant reduction in pain intensity was observed from the third day of treatment with the FDC compared with monotherapy (− 3.1 ± − 1.5 and − 2.6 ± − 1.1 cm, respectively) measured using the VAS (p = 0.011). Regarding the degree of disability, using the Northwick Park Neck Pain Questionnaire (NPQ), statistical difference was observed for the final measurement (7.5%, interquartile range [IQR] 2.5, 10.5; vs. 7.9%, IQR 5.0, 13.8; p = 0.028). A lower proportion of adverse events was reported when using the FDC. Conclusions: The FDC of dexketoprofen/thiamine + pyridoxine + cyanocobalamin vitamins demonstrated superior efficacy and a better safety profile compared with dexketoprofen monotherapy for pain treatment in patients with grade I–II cervical sprains. Clinical Trials Registration: NCT05001555, registered 29 July 2021 (https://clinicaltrials.gov/study/NCT05001555). [ABSTRACT FROM AUTHOR]

Purpose of review: Vitamin B12 (B12, cobalamin) deficiency has been associated with neuropsychiatric symptoms, suggesting a role for B12 supplementation both as a treatment for psychiatric symptoms due to B12 deficiency and as an augmentation strategy for pharmacological treatments of psychiatric disorders. This critical review discusses the major causes of B12 deficiency, the range of psychiatric and non-psychiatric manifestations of B12 deficiency, the indications for testing B12 levels, and the evidence for B12 supplementation for major psychiatric disorders. Recent findings: We find that high-quality evidence shows no benefit to routine B12 supplementation for mild depressive symptoms or to prevent depression. There is very limited evidence on the role of B12 supplementation to augment antidepressants. No high-quality evidence to date suggests a role for routine B12 supplementation in any other major psychiatric disorder. No formal guidelines indicate when clinicians should test B12 levels for common psychiatric symptoms, in the absence of major risk factors for deficiency or cardinal symptoms of deficiency. Summary: No robust evidence currently supports routine B12 supplementation for major psychiatric disorders. However, psychiatrists should be aware of the important risk factors for B12 deficiency and should be able to identify symptoms of B12 deficiency, which requires prompt testing, medical workup, and treatment. Testing for B12 deficiency should be considered for atypical or severe psychiatric presentations. [ABSTRACT FROM AUTHOR]

Background: This systematic review and network meta-analysis aimed to evaluate the three different administration routes of vitamin B12: oral, intramuscular (IM), and sublingual (SL) routes. Methods: We searched four electronic databases (PubMed, Scopus, Web of Science, and Cochrane CENTRAL Register of Controlled Trials). We included only comparative studies. We performed a frequentist network meta-analysis to measure network estimates for the relative outcomes. Moreover, we conducted a pairwise meta-analysis using a random effect model to obtain direct estimates for outcomes. All outcomes were continuous, and the relative treatment effects were pooled as mean difference (MD) with 95% confidence intervals. Results: Thirteen studies were included in the meta-analysis, with a total of 4275 patients. Regarding increasing vitamin B12 levels, the IM route ranked first, followed by the SL route (MD = 94.09 and 43.31 pg/mL, respectively) compared to the oral route. However, these differences did not reach statistical significance owing to the limited number of studies. Regarding the hemoglobin level, the pooled effect sizes showed no difference between all routes of administration that could reach statistical significance. However, the top two ranked administration routes were the oral route (78.3) and the IM route (49.6). Conclusion: All IM, oral, and SL routes of administration of vitamin B12 can effectively increase the level of vitamin B12 without significant differences between them, as thought previously. However, the IM route was the top-ranked statistically but without clinical significance. We found no significant difference among studied administrated routes in all other CBC parameters and homocysteine levels. [ABSTRACT FROM AUTHOR]

Background: Bariatric surgery (BS) is the most effective treatment for severe obesity and it has beneficial effects on glycemic control and metabolism outcomes. However, the effects of BS on nutritional outcomes are controversial. Therefore, we aimed to evaluate the changes in several nutritional outcomes after Roux-en-Y gastric bypass (RYGB). Methods: A comprehensive search was performed using the following databases: PubMed, Embase, Web of Science, Cochrane Library, WanFang and Chinese National Knowledge Infrastructure. The following outcomes were evaluated: vitamin A, 25-hydroxyvitamin D [25(OH)D], calcium, phosphorus, parathormone (PTH), iron, ferritin, vitamin B12, folate, and zinc. The pooled outcomes were expressed as standard mean difference (SMD) and 95% confidence interval (CI) using a random effects model. Results: Fifty-six studies including 5645 individuals with obesity met the inclusion criteria. Serum 25(OH)D (SMD = 0.78, 95%CI 0.38 to 1.20, P < 0.001), phosphorus (SMD = 0.48, 95%CI 0.22 to 0.74, P < 0.001), PTH (SMD = 0.35, 95%CI 0.11 to 0.59, P = 0.005), vitamin B12 (SMD = 1.11, 95%CI 0.41 to 1.80, P = 0.002), and folate (SMD = 1.53, 95%CI 0.77 to 2.28, P < 0.001) significantly increased after RYGB compared with the baseline. Serum ferritin (SMD = − 1.67, 95%CI − 2.57 to − 0.77, P < 0.001), vitamin A (SMD = − 0.64, 95%CI − 0.99 to − 0.29, P < 0.001), and plasma zinc (SMD = − 0.58, 95%CI − 1.09 to − 0.06, P = 0.027) significantly decreased after RYGB. No significant changes in serum calcium (SMD = − 0.14, 95%CI − 0.40 to 0.11, P = 0.219) and iron (SMD = 0.26, 95%CI − 0.11 to 0.64, P = 0.165) were observed after RYGB. Conclusions: Despite the increased levels of 25(OH)D, phosphorus, vitamin B12 and folate, this meta-analysis revealed the unfavorable nutritional consequences after RYGB. [ABSTRACT FROM AUTHOR]

Purpose: Postoperative changes in gut microbiota may occur in patients undergoing Roux-en-Y gastric bypass surgery. In this study, we evaluate the impact of administering probiotic tablets on the gastrointestinal function and metabolic status of these patients. Materials and Methods: This double-blinded randomized clinical trial was conducted from 2021 to 2022 on 135 Roux-en-Y surgery candidates. The intervention group underwent the surgical procedure and started receiving probiotic supplements (Familact Co.) 1 week after surgery; the control group received a placebo. The laboratory and anthropometric data were measured and analyzed before and 3 and 6 months after the intervention. GIQLI questionnaire was also used at the beginning and 6 months after the intervention to evaluate GI symptoms. Results: We observed significantly reduced BMI in both groups after surgeries (P < 0.001). The levels of FBS and HbA1C were significantly lower in the probiotic group compared to the placebo in 3 months (P = 0.02 and P = 0.001, respectively) and 6 months (P < 0.001 for both) after the intervention. The levels of vitamin B12 increased significantly in the probiotic group (P < 0.001), and the values were substantially higher than the placebo group in 3 and 6 months (P < 0.001), respectively. Analysis of the GIQLI questionnaire before and 6 months after interventions also revealed significant improvement in the GIQLI score in both groups (P < 0.001 for probiotics and P = 0.03 for placebo). Conclusion: Probiotic supplement administration following RYGB improves patients' vitamin and metabolic profile, as well as GI function, although it cannot significantly affect weight loss. [ABSTRACT FROM AUTHOR]

This cross-sectional study investigated the association between glaucoma and B vitamin dietary intake. A total of 5025 enrolled individuals participated in self-reported glaucoma questionnaire and 3264 participated in International Society Geographical and Epidemiological Ophthalmology (ISGEO) criteria. In self-reported glaucoma, the risk of having self-reported glaucoma was lower in the third quartile of vitamin B1 intake (odds ratio [odds ratio [OR] 0.63, 95% confidence interval [CI] 0.40–0.97), and P trend (P trend = 0.004) for vitamin B12 was significant; in males, the third quartile of vitamin B1 intake (OR 0.44, 95% CI 0.24–0.83) and the fourth quartile of vitamin B2 intake (OR 0.39, 95% CI 0.17–0.89) were associated with a lower risk. In glaucoma based on ISGEO criteria, the increase of niacin intake (OR 0.94, 95% CI 0.89–0.99) was negatively associated with the odds of self-reported glaucoma. After sex-stratified analysis, the third quartile of vitamin B6 intake (OR 0.21, 95% CI 0.08–0.60) in males were associated with reduced odds of glaucoma. The restricted cubic spline analysis revealed a nonlinear association of vitamin B2 (p for nonlinearity = 0.04) and B9 (p for nonlinearity = 0.024) intake with glaucoma diagnosed by ISGEO criteria in females. [ABSTRACT FROM AUTHOR]

Purpose: The previous studies have suggested that serum homocysteine (Hcy) and vitamin B levels are potentially related to autism spectrum disorder (ASD). However, the causality between their concentrations and ASD risk remains unclear. To elucidate this genetic association, we used a Mendelian randomization (MR) design. Methods: For this MR analysis, 47 single-nucleotide polymorphisms (SNPs)—13 related to Hcy, 13 to folate, 14 to vitamin B6, and 7 to vitamin B12—were obtained from a large-scale Genome-Wide Association Studies (GWAS) database and employed as instrumental variables (IVs). Our study used three approaches to calculate the MR estimates, including inverse-variance weighted (IVW) method, MR-Egger method, and weighted median (WM) method. Among these, the IVW method served as our primary MR method. False discovery rate (FDR) was implemented to correct for multiple comparisons. We also performed a series of sensitivity analyses, including Cochran's Q test, MR-Egger's intercept, MR-PRESSO, leave-one-out analysis, and the funnel plot. Results: Univariable Mendelian randomization (UVMR) analysis revealed a statistical association between serum vitamin B12 levels and ASD risk (OR = 1.68, 95% CI 1.12–2.52, P = 0.01) using the IVW method. However, neither the WM method (OR = 1.57, 95% CI 0.93–2.66, P = 0.09) nor the MR-Egger method (OR = 2.33, 95% CI 0.48–11.19, P = 0.34) was significantly association with higher levels of serum vitamin B12 and ASD risk. Additionally, we found no evidence of causal relationships between serum levels of vitamin B6, folate, Hcy, and ASD risk. After correcting for the FDR, the causality between serum vitamin B12 levels and ASD risk remained significant (q value = 0.0270). Multivariate Mendelian randomization (MVMR) analysis indicated an independent association between elevated serum vitamin B12 levels and the risk of ASD (OR = 1.74, 95% CI 1.03–2.95, P = 0.03) using the IVW method, but this finding was inconsistent when using the WM method (OR = 1.73, 95% CI 0.89–3.36, P = 0.11) and MR-Egger method (OR = 1.60, 95% CI 0.95–2.71, P = 0.08). Furthermore, no causal associations were observed for serum levels of vitamin B6 and folate in MVMR analysis. Sensitivity analyses confirmed that these results were reliable. Conclusion: Our study indicated that elevated serum vitamin B12 levels might increase the risk of ASD. The potential implications of our results for ASD risk warrant validation in randomized clinical trials. [ABSTRACT FROM AUTHOR]

Vitamin B12 (cobalamin) deficiency is common in patients with rheumatic diseases. Pernicious anemia is a well-known cause, but recent reports suggest that autoimmune-derived deficiency may not be limited to this cause alone. Symptoms of low vitamin B12 concentration are often deceptive, mimicking and overlapping with symptoms of other conditions. Neuropsychiatric manifestations, anemia, and fatigue are frequently attributed to a rheumatic disease without further evaluation. In this study, we present three cases of patients with neuropathic pain, depression, fatigue, and muscle weakness, initially attributed to a rheumatic disease, which almost completely resolved after implementing vitamin B12 supplementation. Furthermore, we provide an overview of current scientific reports regarding the potential use of cobalamin in rheumatology. Treatment of pain and neuropathy, often very challenging in long-lasting rheumatic diseases, can be more effective after a course of vitamin B12, even when no apparent deficiency is detected in laboratory tests. Considering recent research demonstrating vitamin B12's nerve-protecting properties, we recommend that physicians should assess vitamin B12 levels early in the diagnostic process of rheumatic diseases. In specific cases, physicians should consider cobalamin supplementation regardless of vitamin B12 serum concentration. [ABSTRACT FROM AUTHOR]

Background: Outliers can influence regression model parameters and change the direction of the estimated effect, over-estimating or under-estimating the strength of the association between a response variable and an exposure of interest. Identifying visit-level outliers from longitudinal data with continuous time-dependent covariates is important when the distribution of such variable is highly skewed. Objectives: The primary objective was to identify potential outliers at follow-up visits using interquartile range (IQR) statistic and assess their influence on estimated Cox regression parameters. Methods: Study was motivated by a large TEDDY dietary longitudinal and time-to-event data with a continuous time-varying vitamin B12 intake as the exposure of interest and development of Islet Autoimmunity (IA) as the response variable. An IQR algorithm was applied to the TEDDY dataset to detect potential outliers at each visit. To assess the impact of detected outliers, data were analyzed using the extended time-dependent Cox model with robust sandwich estimator. Partial residual diagnostic plots were examined for highly influential outliers. Results: Extreme vitamin B12 observations that were cases of IA had a stronger influence on the Cox regression model than non-cases. Identified outliers changed the direction of hazard ratios, standard errors, or the strength of association with the risk of developing IA. Conclusion: At the exploratory data analysis stage, the IQR algorithm can be used as a data quality control tool to identify potential outliers at the visit level, which can be further investigated. [ABSTRACT FROM AUTHOR]

Most phytoplankton, including harmful algal bloom (HAB)-forming species, have an absolute requirement for vitamin B12 (cobalamin). However, the cycling of vitamin B12 in the ocean is still poorly understood. For example, in the Ariake Sea, where local fisheries have been affected by HABs, the impact of vitamin B12 on phytoplankton dynamics has never been evaluated. This study reports the surface distribution of cyanocobalamin (CN-B12, a type of vitamin B12) in the Ariake Sea and its adjacent areas. The field measurements were complemented with an additional onboard CN-B12 incubation experiment to elucidate the importance of the coenzyme on the growth of natural phytoplankton communities. Dissolved CN-B12 behaved dynamically and was often depleted in surface waters. Dominant phytoplankton in the Ariake Sea changed seasonally; all these taxa include vitamin B12 auxotrophs. The distribution of CN-B12 was controlled by dynamic production and consumption by natural phytoplankton and bacterial communities. We attempted to measure the concentration of particulate CN-B12; it was undetectable suggesting that CN-B12 form of vitamin B12 is not dominant inside the cell. No clear relationship existed between CN-B12 and any oceanographic parameters, suggesting that river discharge is unlikely a major source of CN-B12 in this area. Bottle incubation experiments showed that CN-B12 and nitrate additions promoted the growth of diatom Chaetoceros spp., implying that some phytoplankton groups are co-limited by them. These preliminary results suggest that vitamin B12 may affect the composition of the phytoplankton community in the Ariake Sea. [ABSTRACT FROM AUTHOR]

Human and animal tuberculosis is caused by the Mycobacterium tuberculosis Complex (MTBC), which has evolved a genomic decay of cobalamin (vitamin B12) biosynthetic genes. Accordingly, and in sharp contrast to environmental, opportunistic and ancestor mycobacteria; we demonstrate that M. tuberculosis (Mtb), M. africanum, and animal-adapted lineages, lack endogenous production of cobalamin, yet they retain the capacity for exogenous uptake. A B12 anemic model in immunocompromised and immunocompetent mice, demonstrates improved survival, and lower bacteria in organs, in B12 anemic animals infected with Mtb relative to non-anemic controls. Conversely, no differences were observed between mice groups infected with M. canettii, an ancestor mycobacterium which retains cobalamin biosynthesis. Interrogation of the B12 transcriptome in three MTBC strains defined L-methionine synthesis by metE and metH genes as a key phenotype. Expression of metE is repressed by a cobalamin riboswitch, while MetH requires the cobalamin cofactor. Thus, deletion of metE predominantly attenuates Mtb in anemic mice; although inactivation of metH exclusively causes attenuation in non-anemic controls. Here, we show how sub-physiological levels of B12 in the host antagonizes Mtb virulence, and describe a yet unknown mechanism of host-pathogen cross-talk with implications for B12 anemic populations. Campos-Pardos et al show that the virulence of Mycobacterium tuberculosis is dependent on sufficient uptake of exogenous vitamin B12 from host serum and this phenotype is not conserved in environmental, opportunistic and ancestral lineages. [ABSTRACT FROM AUTHOR]

Purpose: To our knowledge, there are very few studies evaluating if the levels of folate modify the risk of cervical intraepithelial neoplasia grade 2 and higher (CIN2+ and CIN3+) associated with the levels of HPV genome methylation, two cofactors related to single carbon metabolism and independently associated with cervical cancer in previous studies. We conducted a case–control study nested in a three-arm randomized clinical pragmatic trial (ASCUS-COL trial) to evaluate the risk of CIN3+ associated with methylation levels according to serum folate concentrations. Methods: Cases (n = 155) were women with histologically confirmed CIN2+ (113 CIN2, 38 CIN3, and 4 SCC) and controls were age and follow-up time at diagnosis-matched women with histologically confirmed ≤ CIN1 (n = 155), selected from the 1122 hrHPV + women of this trial. The concentrations of serum folate were determined by the radioimmunoassay SimulTRAC-SNB-VitaminB12/Folate-RIAKit and the methylation levels by the S5 classifier. Stepwise logistic regression models were used to estimate the association between folate or methylation levels and CIN2+ or CIN3+. The joint effect of folate levels and methylation on the risk of CIN3+ was estimated using combinations of categorical stratifications. Results: Folate levels were significantly lower in women with CIN3+ than in other diagnostic groups (p = 0.019). The risk of CIN3+ was eight times higher (OR 8.9, 95% CI 3.4–24.9) in women with folate deficiency and high methylation levels than in women with normal folate and high methylation levels (OR 1.4, 95% CI 0.4–4.6). Conclusion: High methylation and deficient folate independently increased the risk of CIN3+ while deficient folate combined with high methylation was associated with a substantially elevated risk of CIN3+. [ABSTRACT FROM AUTHOR]

Background: B12 deficiency, which can be seen in type 2 DM patients using metformin, can cause peripheral nerve damage that can easily be confused with peripheral neuropathy, a complication of diabetes. Therefore, early diagnosis is important in patients. Objective: In our study, we aimed to investigate benefit of Active B12 measurement in diagnosing B12 deficiency, as it might be a better alternative in follow-up of B12 levels in type 2 DM patients using metformin. Methods: Patients were divided into three groups according to their Total B12 levels: Deficient, Borderline and Sufficient. Homocysteine and Active B12 (holotranscobalamin) levels were studied with Chemiluminescent Microparticle Immunoassay (CMIA) for quantitative determination. Duration of use, daily metformin dose, and other parameters were collected from records and interviews. Results: A statistically significant positive correlation was found between Total B12 and Active B12 (r = 0.624, p = 0.000). A statistically significant negative correlation was found between metformin dose and Active B12 and Total B12 levels (r = -0.309, r = -0.212, respectively; p < 0.05). While effects of metformin dose and duration of use groups were not found statistically significant in binary logistic regression analysis for Total B12 groups, the OR value for Active B12 was found to be 5.575 (95% CI 1.456–21.343, p = 0.012). Conclusions: It is important to closely follow up Type2 DM patients with high daily metformin dose in terms of B12 deficiency. Active B12 is a significant predictor of B12 deficiency compared to other parameters. [ABSTRACT FROM AUTHOR]

Background: The recreational use of nitrous oxide (N2O) has gained popularity over recent years. We present a case series of excessive N2O users with neurological complications. Methods: In this retrospective three-centre study, we used a text mining algorithm to search for patients who used N2O recreationally and visited a neurologist. Results: We identified 251 patients. The median duration of N2O use was 11 months (interquartile range [IQR], 3–24) and the median amount of N2O used per occasion 1.6 kg (IQR 0.5–4.0). Clinically, polyneuropathy (78%), myelopathy (41%), and encephalopathy (14%) were the most common diagnoses. An absolute vitamin B12 deficiency of < 150 pmol/L was found in 40% of cases. In 90%, at least one indicator of functional vitamin B12 status (vitamin B12, homocysteine, or methylmalonic acid) was abnormal. MRI showed signs of myelopathy in 30/55 (55%) of cases. In 28/44 (64%) of those who underwent electromyography, evidence of axonal polyneuropathy was found. Most (83%) patients were treated with vitamin B12 supplementation, and 23% were admitted to the hospital. Only 41% had follow-up for ≥ 30 days, and 79% of those showed partial or complete recovery. Conclusions: In this case series of excessive N2O users, we describe a high prevalence of polyneuropathy, myelopathy, and encephalopathy. Stepwise testing for serum levels of vitamin B12, homocysteine, and methylmalonic acid may support the clinical diagnosis. Due to low sensitivity, MRI of the spinal cord and electromyography have limited value. Effective treatment should incorporate supplementation of vitamin B12 and strategies to prevent relapses in N2O use. [ABSTRACT FROM AUTHOR]

We would like to provide an updated comprehensive perspective and identify the components linked to chronic spontaneous urticaria (CSU) without specific triggers in autoimmune atrophic gastritis (AAG). AAG is an organ-specific autoimmune disease that affects the corpus-fundus gastric mucosa. Although we lack a unified explanation of the underlying pathways, when considering all paediatric patients reported in the literature, alterations result in gastric neuroendocrine enterochromaffin-like (ECL) cell proliferation and paracrine release of histamine. Several mechanisms have been proposed for the pathogenesis of CSU, with much evidence pointing towards AAG and ECL cell responses, which may be implicated as potential factors contributing to CSU. The excessive production/release of histamine into the bloodstream could cause or trigger exacerbations of CSU in AAG, independent of Helicobacter pylori; thus, the release of histamine from ECL cells may be the primary modulator. Conclusion: Considering the understanding of these interactions, recognising the respective roles of AAG in the pathogenesis of CSU may strongly impact the diagnostic workup and management of unexplained/refractory CSU and may inform future research and interventions in the paediatric population. What is Known: • Autoimmune atrophic gastritis is a chronic immune-mediated inflammatory disease characterised by the destruction of the oxyntic mucosa in the gastric body and fundus, mucosal atrophy, and metaplastic changes. • Autoimmune atrophic gastritis in paediatric patients is important because of the poor outcome and risk of malignancy and possibly underestimated entities primarily reported in single-case reports. What is New: • Upper gastrointestinal inflammatory disorders, independent of H. pylori, have been implicated as potential inducing factors in the development of chronic spontaneous urticaria. • If a paediatric patient presents with symptoms such as anaemia, reduced vitamin B12 levels, recurrent urticaria with no other detectable aetiology, positive anti-parietal cell antibodies, and elevated gastrin levels, autoimmune atrophic gastritis should be considered a possible cause of chronic urticaria. [ABSTRACT FROM AUTHOR]

In this study, the use of low-energy methods for nanoemulsification of vitamin B12 was investigated to protect this bioactive substance. The effects of sunflower oil concentrations (4–8%), Tween 80 (8–16%), and vitamin B12 (5–15%) on the physicochemical properties of B12 nanoemulsion were evaluated using response surface methodology (RSM). The results indicated that the quadratic model was the most fitting model for experimental data. Optimization revealed that the optimal formulation contained 6.5% sunflower oil, 9.6% Tween 80, and 13% vitamin B12, resulting in maximum efficiency, viscosity, and vitamin B12 content, as well as minimum pH, turbidity, p-Anisidine index, particle size, and polydispersity index (PDI). Under optimal conditions, pH, viscosity, turbidity, efficiency, vitamin B12, p-Anisidine index, PDI, and particle size were 7.24, 17.0024 cp, 2.19, 51.98%, 5.54 ppm, 0.01, 0.34, and 322 nm, respectively. This study highlights the effectiveness of spontaneous emulsification as a carrier for the encapsulation of bioactive compounds. [ABSTRACT FROM AUTHOR]

Purpose: Dietary micronutrient intakes of iron, folate and vitamin B12 are known to influence hemoglobin. Low maternal hemoglobin (maternal anemia) has been linked to low birthweight and other adverse health outcomes in the fetus and infant. Our primary aim was to explore relationships between maternal dietary micronutrient intakes, maternal full blood count (FBC) parameters and fetal abdominal circumference (AC) and estimated fetal weight (EFW) growth trajectories. Secondarily, we aimed to assess relationships between maternal dietary micronutrient intakes, maternal hemoglobin values and placental weight and birthweight. Methods: Mother–child pairs (n = 759) recruited for the ROLO study were included in this analysis. Maternal dietary micronutrient intakes were calculated from food diaries completed during each trimester of pregnancy. FBC samples were collected at 13- and 28-weeks' gestation. Fetal ultrasound measurements were recorded at 20- and 34-weeks' gestation. Growth trajectories for AC and EFW were estimated using latent class trajectory mixture models. Results: Dietary intakes of iron and folate were deficient for all trimesters. Mean maternal hemoglobin levels were replete at 13- and 28-weeks' gestation. Dietary iron, folate and vitamin B12 intakes showed no associations with fetal growth trajectories, placental weight or birthweight. Lower maternal hemoglobin concentrations at 28 weeks' gestation were associated with faster rates of fetal growth and larger placental weights and birthweights. Conclusion: The negative association between maternal hemoglobin at 28 weeks' gestation and accelerated fetal and placental growth may be due to greater consumption of maternal iron and hemoglobin by fetuses' on faster growth trajectories in addition to placental biochemical responses to lower oxygen states. [ABSTRACT FROM AUTHOR]

Objective: This systematic review and meta-analysis study aimed to estimate changes in blood nutrient concentrations and nutrient deficiencies in adolescents following bariatric surgery. Methods: We searched PubMed, Scopus, and the Web of Science to find studies published between January 2000 and August 2023. Observational studies reporting the mean blood concentration of nutrients before and after bariatric surgery or the proportion of nutrient deficiencies after the surgery in healthy adolescents were selected. Results: Fifteen studies were included. Gastric bypass and sleeve gastrostomy were the most common types of surgery. Vitamin D, iron, or ferritin, vitamin B12, calcium, and folic acid were the most studied nutrients, respectively. Other nutrients examined in the studies included zinc, phosphorus, and albumin. The serum ferritin increased by 21 mcg/L (95% CI = 10.0, 32.0 mcg/L) after the surgery, but there were no significant alterations in other nutrients. The postoperative prevalence of low albumin, ferritin, vitamin D, and vitamin B12 levels was 10%, 49%, 41%, and 20%, respectively. Also, 23% had an iron deficiency, and 10% had a calcium deficiency after bariatric surgery. Conclusions: The serum ferritin level increased following bariatric surgery in adolescents. Vitamin D and ferritin deficiencies were estimated to be present in more than one-third of adolescents after the surgery. [ABSTRACT FROM AUTHOR]

Vitamins and minerals are of fundamental importance to numerous human functions that are essential to optimise athlete performance. Athletes incur a high turnover of key vitamins and minerals and are therefore dependent on sufficient energy intake to replenish nutrient stores. However, many athletes are poor at servicing their energy replenishment needs, especially female athletes, and although a 'food first approach' to meeting nutrient requirements is the primary goal, it may be important for some athletes to consider a vitamin and/or mineral supplement to meet their daily needs. When working to determine if an athlete requires vitamin or mineral supplements, practitioners should use a robust framework to assess the overall energy requirements, current dietary practices and the biological and clinical status of their athletes. Of note, any supplementation plan should account for the various factors that may impact the efficacy of the approach (e.g. athlete sex, the nutrient recommended dietary intake, supplement dose/timing, co-consumption of other foods and any food–drug interactions). Importantly, there are numerous vitamins and minerals of key importance to athletes, each having specific relevance to certain situations (e.g. iron and B vitamins are significant contributors to haematological adaptation, calcium and vitamin D are important to bone health and folate is important in the female athlete); therefore, the appropriate supplement for a given situation should be carefully considered and consumed with the goal to augment an athlete's diet. [ABSTRACT FROM AUTHOR]

Methylation is a ubiquitous and permanent key biochemical process playing a major role in gametogenesis and embryogenesis in relation to epigenetics and imprinting. Methylation relies on a unique cofactor S-Adenosyl Methionine: SAM. Release of the methyl group onto target molecules is followed by liberation of S-Adenosyl Homocysteine (SAH), and then homocysteine (Hcy), both potent inhibitors of the methylation process. Defective recycling of homocysteine, leading to Hyperhomocysteinemia, is mainly due to reduced activity of MTHFR (Methylene TetraHydroFolate Reductase). However, we described here, in a woman attending an ART program, a rather rare syndrome: The Folate trap syndrome. Due to vitamin B12 deficiency (malabsorption), Hcy cannot be recycled to methionine by the methionine synthase. Transmethylation activity is weak and leads to Hhcy (Hyperhomocysteinhemia). Her Hhcy, over 16µM, was resistant to 5MTHF (5 Methyltetrahydrofolate) associated with a support of the one carbon cycle, a classical efficient treatment for elevated homocysteine. Treatment with Methylcobalamine (associated with adenosyl Cobalamine) allowed a Hcy drop down to 10 µM. Knowing the pleiotropic negative impact of Hcy on gametes, embryos and pregnancy in general, we strongly recommend a Hcy dosage in both members of couples seeking treatment for pregnancy. [ABSTRACT FROM AUTHOR]

Vitamin deficiency syndromes and blood–brain barrier (BBB) dysfunction are frequent phenomena in psychiatric conditions. We analysed the largest available first-episode schizophrenia-spectrum psychosis (FEP) cohort to date regarding routine cerebrospinal fluid (CSF) and blood parameters to investigate the association between vitamin deficiencies (vitamin B12 and folate) and BBB impairments in FEP. We report a retrospective analysis of clinical data from all inpatients that were admitted to our tertiary care hospital with an ICD-10 diagnosis of a first-episode F2x (schizophrenia-spectrum) between January 1, 2008 and August 1, 2018 and underwent a lumbar puncture, blood-based vitamin status diagnostics and neuroimaging within the clinical routine. 222 FEP patients were included in our analyses. We report an increased CSF/serum albumin quotient (Qalb) as a sign of BBB dysfunction in 17.1% (38/222) of patients. White matter lesions (WML) were present in 29.3% of patients (62/212). 17.6% of patients (39/222) showed either decreased vitamin B12 levels or decreased folate levels. No statistically significant association was found between vitamin deficiencies and altered Qalb. This retrospective analysis contributes to the discussion on the impact of vitamin deficiency syndromes in FEP. Although decreased vitamin B12 or folate levels were found in approximately 17% of our cohort, we found no evidence for significant associations between BBB dysfunction and vitamin deficiencies. To strengthen the evidence regarding the clinical implications of vitamin deficiencies in FEP, prospective studies with standardized measurements of vitamin levels together with follow-up measurements and assessment of symptom severity in addition to CSF diagnostics are needed. [ABSTRACT FROM AUTHOR]

Abstract—Vitamin B12, or cobalamin, is essential for normal body function and is used in the therapies of different diseases. Vitamin B12 has anti-inflammatory and antioxidant properties that can play an important role in the prevention of some diseases. On the other hand, it has been reported that vitamin B12 in combination with such reducing agents as ascorbate (vitamin C) and thiols showed prooxidant activity. This review provides information on the roles of vitamin B12 in diseases accompanied by inflammation and oxidative stress and the effects of vitamin B12 administrated alone and in combinations with different reducing agents such as ascorbate and thiols on oxidative stress. In addition, the mechanisms of prooxidant actions of combinations of vitamin B12 with these reducing agents depending on the form of vitamin B12 (hydroxocobalamin and cyanocobalamin) are discussed. Understanding the mechanisms of prooxidant action of vitamin B12 is necessary for developing strategies for therapeutic administration of vitamin B12. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is characterized by early-appearing social communication deficits, with genetic and environmental factors potentially playing a role in its etiology, which remains largely unknown. During pregnancy, certain deficiencies in critical nutrients are mainly associated with central nervous system impairment. The vitamin B9 (folate) is primarily related to one-carbon and methionine metabolism, participating in methyl donor generation. In addition, supplementation with folic acid (FA) is recommended by the World Health Organization (WHO) in the first three gestational months to prevent neural tube defects. Vitamin B12 is related to folate regeneration, converting it into an active form. Deficiencies in this vitamin have a negative impact on cognitive function and brain development since it is involved in myelin synthesis. Vitamin D is intimately associated with Ca2+ levels, acting in bone development and calcium-dependent signaling. This vitamin is associated with ASD at several levels since it has a relation with ASD genes and oxidative stress environment. This review carries the recent literature about the role of folate, vitamin B12, and vitamin D in ASD. In addition, we discuss the possible impact of nutrient deficiency or hypersupplementation during fetal development. On the other hand, we explore the biases of vitamin supplementation studies such as the loss of participants in retrospective studies, as well as multiple variants that are not considered in the conclusion, like dietary intake or auto-medication during pregnancy. In this regard, we aim to contribute to the discussion about the role of vitamins in ASD currency, but also in pregnancy and fetal development as well. Furthermore, stress during pregnancy can be an ASD predisposition, with cortisol as a regulator. In this view, we propose that cortisol is the bridge of susceptibility between vitamin disorders and ASD prevalence. [ABSTRACT FROM AUTHOR]

Fortified rice kernels (FRK) are novel extruded products that are rice-shaped and fortified with folic acid, cyanocobalamin, and iron to manage the prevalence of anemia in developing countries like India. Analysis of micronutrient content in FRK is necessary to ensure its compliance with the legal limits requirement of the added micronutrients. The present study aims to develop an easy, simple, and quick extraction method for analyzing the folic acid content of FRK using HPLC equipped with a variable wavelength detector. Ultrasonic-assisted extraction with probe-type and water-bath-type ultrasonication units was compared, and the extraction conditions were optimized. The time and temperature combinations were 30, 40, and 50°C for 1 to 15 min. Ultrasonic-assisted direct probe extraction at 30°C for 5 min gave the best recovery (98%) with good repeatability. The method showed good linearity with R2 = 0.999, 91 to 107% recovery, and repeatability with relative standard deviation (RSD) ≤ 4%. The method's limit of detection (LoD) and quantification (LoQ) were 0.35 and 1.17 mg/kg, respectively. A control chart was used to determine the reliability of the method over the course of ten months, and values of folic acids were found not to exceed the upper and lower control limits. The stability of folic acid in FRK after extrusion and during rinsing and different cooking methods (open vessel, microwave, and pressure cooker) were analyzed. The retention of folic acid in cooked FRK ranged from 71.64 to 95.15%. [ABSTRACT FROM AUTHOR]

To block and weaken the bacterial branched VB12 synthetic metabolic pathway, homologous recombination technology was used to knock out the sirohaem synthase gene cysG located in the chromosome and the endogenous A plasmid of the Ensifer adhaerens Casida A strain, and the expression of the uroporphyrinogen III decarboxylase gene hemE was weakened by weak promoter substitution. The growth of the engineered strains and the production of VB12 and haem were analysed and measured in the engineered strains, aiming to provide a new strategy for enhancement of VB12 biosynthesis. The results showed that the chromosomal cysG gene knockout strain ΔcysG, endogenous A plasmid cysG gene knockout strain ΔpAcysG and cysG gene double knockout strain ΔcysGΔpAcysG grew normally, with VB12 yield increases of 19.9%, 11.2%, and 27.4% compared to the starting strain, respectively. In the background of the cysG gene knockout strain, the expression of the hemE gene was weakened, resulting in the generation of the strain ΔcysGΔpAcysG-E-pdnaD, and the VB12 yield of ΔcysGΔpA cysG-E-pdnaD reached 114.17 ± 5.77 mg L−1, an increase of 45.1% compared to the yield of the original strain. The above results indicate that the strategy of increasing VB12 production by knocking out the haem synthesis pathway and weakening the haem synthesis pathway is effective. [ABSTRACT FROM AUTHOR]

Cognitive impairment is a progressive disorder that affects the ageing population. With the increase in the mean age of our population, it is becoming a public health problem. Homocysteinemia has been implicated in cognitive impairment. Whilst it is modulated by vitamins B12 and folate, it acts through MMPs 2 and 9. To assesses the relationship of cognitive impairment with homocysteine, B12, folate and MMPs 2 and 9, so as to detect cases of mild cognitive impairment which are potentially reversible, blood samples were drawn from 73 enrolled subjects, with and without cognitive impairment on basis of Montreal cognitive assessment (MoCA) score < 25 or ≥ 25, respectively. Homocysteine, B12, folate and MMPs2 and 9 were estimated. Correlation between MoCA score and these parameters was elucidated. After adjusting for age and gender, homocysteine was the only significant independent predictor of MoCA score. Cut-off of homocysteine for prediction of MoCA < 25 was derived at 13.5 µmol/L(PPV = 59.6%; NPV = 79.2%). The equation derived for calculation of MoCA score from homocysteine is: MoCA score = 32.893 + [(− 0.223)(homocysteine in μmol/L)]. Homocysteine > 13.5 μmol/L predicts low MoCA (< 25) with 84.8% sensitivity and 50% specificity. Hence, patients with an Hcy > 13.5 μmol/L should be administered B12 and folate to reduce homocysteine, a modifiable risk factor of cognitive decline. Also, a novel equation for calculating MoCA score from homocysteine has been derived. Using this derived equation to calculate MoCA score, it may be possible to identify asymptomatic subjects with early cognitive impairment. [ABSTRACT FROM AUTHOR]

Cobalamin-dependent methionine synthase (MS) is a key enzyme in methionine and folate one-carbon metabolism. MS is a large multi-domain protein capable of binding and activating three substrates: homocysteine, folate, and S-adenosylmethionine for methylation. Achieving three chemically distinct methylations necessitates significant domain rearrangements to facilitate substrate access to the cobalamin cofactor at the right time. The distinct conformations required for each reaction have eluded structural characterization as its inherently dynamic nature renders structural studies difficult. Here, we use a thermophilic MS homolog (tMS) as a functional MS model. Its exceptional stability enabled characterization of MS in the absence of cobalamin, marking the only studies of a cobalamin-binding protein in its apoenzyme state. More importantly, we report the high-resolution full-length MS structure, ending a multi-decade quest. We also capture cobalamin loading in crystallo, providing structural insights into holoenzyme formation. Our work paves the way for unraveling how MS orchestrates large-scale domain rearrangements crucial for achieving challenging chemistries. Methionine synthase (MS) harnesses B12 and flexibility to catalyze three different reactions on one protein. The full-length structure of MS yields insights into a protein that epitomizes controlled dynamics to dictate chemical outcome. [ABSTRACT FROM AUTHOR]

Ostreobium, the major algal symbiont of the coral skeleton, remains understudied despite extensive research on the coral holobiont. The enclosed nature of the coral skeleton might reduce the dispersal and exposure of residing bacteria to the outside environment, allowing stronger associations with the algae. Here, we describe the bacterial communities associated with cultured strains of 5 Ostreobium clades using 16S rRNA sequencing. We shed light on their likely physical associations by comparative analysis of three datasets generated to capture (1) all algae associated bacteria, (2) enriched tightly attached and potential intracellular bacteria, and (3) bacteria in spent media. Our data showed that while some bacteria may be loosely attached, some tend to be tightly attached or potentially intracellular. Although colonised with diverse bacteria, Ostreobium preferentially associated with 34 bacterial taxa revealing a core microbiome. These bacteria include known nitrogen cyclers, polysaccharide degraders, sulphate reducers, antimicrobial compound producers, methylotrophs, and vitamin B12 producers. By analysing co-occurrence networks of 16S rRNA datasets from Porites lutea and Paragoniastrea australensis skeleton samples, we show that the Ostreobium-bacterial associations present in the cultures are likely to also occur in their natural environment. Finally, our data show significant congruence between the Ostreobium phylogeny and the community composition of its tightly associated microbiome, largely due to the phylosymbiotic signal originating from the core bacterial taxa. This study offers insight into the Ostreobium microbiome and reveals preferential associations that warrant further testing from functional and evolutionary perspectives. [ABSTRACT FROM AUTHOR]

Peptide nucleic acid (PNA) is a nucleic acid mimic with high specificity and binding affinity to natural DNA or RNA, as well as resistance to enzymatic degradation. PNA sequences can be designed to selectively silence gene expression, which makes PNA a promising tool for antimicrobial applications. However, the poor membrane permeability of PNA remains the main limiting factor for its applications in cells. To overcome this obstacle, PNA conjugates with different molecules have been developed. This mini-review focuses on covalently linked conjugates of PNA with cell-penetrating peptides, aminosugars, aminoglycoside antibiotics, and non-peptidic molecules that were tested, primarily as PNA carriers, in antibacterial and antiviral applications. The chemistries of the conjugation and the applied linkers are also discussed. [ABSTRACT FROM AUTHOR]

This article describes Woodward's classic work, aided by modern contributions that completed its absolute structure. In his era, Woodward deciphered the detailed structural features as if they were the relic Aramaic alphabet inscribed in the macrolide dead-sea scrolls with only the aid of a modern-day dictionary. His success in applying these early ideas to unveil its major macrolide structure was a self-confirmation of their validity as biosynthetic principles. [ABSTRACT FROM AUTHOR]

Objectives: To define the vitamin B12 levels and other micronutrients status in severe acute malnutrition (SAM) children. Methods: This was a prospective hospital based cross-sectional study. Inclusion criteria: Children with severe acute malnutrition as per WHO criteria. Exclusion criteria: (i) Pernicious anemia (ii) Autoimmune gastritis (iii) SAM children on exclusive vitamin B12 supplementation. All enrolled children underwent a detailed clinical history, general physical examination with more emphasis on clinical features of vitamin B12 and other micronutrients deficiencies. Three ml of venous blood was collected to estimate vitamin B12 and other micronutrients. Primary outcome was percentage of deficiency of serum vitamin B12, zinc, copper, selenium, manganese, molybdenum and cobalt in SAM children. Results: Fifty children were included in the study. The mean age of children was 15.60±12.90 mo with male to female ratio 0.85:1. The common clinical presentation in order of frequency were upper respiratory infection (URI) symptoms 35 (70%), hepatomegaly 24 (48%), Hyperpigmentation 17 (34%), angular cheilitis 14 (28%), tremors 11 (22%), edema 07 (14%), and hypotonia 05 (10%). Anemia was found in 44 (88%) children. Prevalence of vitamin B12 deficiency was 34%. Other micronutrient deficiencies observed were cobalt 24 (100%), copper 05 (12%), zinc 04 (9.5%), and molybdenum 03 (12.5%). No statistical significance was found between clinical symptoms and levels of vitamin B12 with different age and sex. Conclusions: Prevalence of low vitamin B12 and cobalt were more common than other micronutrients. [ABSTRACT FROM AUTHOR]

Purpose: Micronutrient deficiencies are common after Roux-en-Y gastric bypass (RYGB). This study explores whether vitamin and mineral deficiency was associated with adherence to recommended supplementation 12 years after RYGB. Materials and Methods: The cross-sectional Bariatric Surgery Observation Study (BAROBS) was conducted in 2018–2020 at three hospitals in Central Norway. We report data on 490 patients' self-reported adherence to recommended supplements and vitamin and mineral levels in the blood. The patients, who had RYGB between 2003 and 2009, were recommended an over-the-counter multivitamin-mineral supplement, calcium/vitamin D (1000 mg/20 µg) and vitamin B12 injections (reimbursed), since bariatric supplements were not available then. Results: Mean (SD) age was 40.1 ± 9 years at RYGB, and time to follow-up 11.7 ± 1.6 years. Of 490 patients, 393 (80%) were women. Among 361 (74%) patients' adherent to multivitamin-mineral supplements; folate, vitamin B2, and vitamin B6 deficiency were present in 39 (11%), 103 (29%), and 63 (17%) patients, respectively. The same deficiencies occurred in 44 (34%), 67 (52%), and 67 (52%) patients' non-adherent to recommendations. Although 466 (95%) patients reported adherence to vitamin B12 supplements, sub-optimal levels were found in 73 (16%) patients. Though 336 (69%) patients adhered to calcium/vitamin D supplements (1000 mg/20 µg), sub-optimal vitamin D levels (< 75 nmol/l) were found in 174/336 (52%) adherent patients and 120/154 (78%) non-adherent patients. Conclusion: Twelve years after RYGB, adherence to supplements, though in sub-optimal doses of new recommendations, decreases the probability of vitamin and mineral deficiency, especially for thiamine, vitamin B2, vitamin B6, folate, vitamin B12, and vitamin D, but does not eliminate it. [ABSTRACT FROM AUTHOR]

Previous methods for vitamin B12 (B12) analysis have extensively used cyanidation conversion with the intention of converting all cobalamins to cyanocobalamin (CNCbl) for total B12 determination. This approach has been favored for its advantages in reducing the number of analytes, increasing analyte concentration, and improving analyte stability. However, the present study revealed underlying limitations associated with this approach. First, a stable isotope dilution assay (SIDA) determining total B12 as CNCbl after cyanidation conversion (conversion SIDA method) was developed. Method validation demonstrated good sensitivity, recovery, accuracy, and reproducibility for the target analyte CNCbl. However, subsequent application of the conversion method to real meat samples showed incomplete conversions of cobalamins. These inconsistencies revealed day-to-day variability and reliability challenges associated with the cyanidation process. It was not possible to identify this issue during method validation as CNCbl was spiked as the sole analyte and it requires no further cyanidation conversion. The application of LC-MS/MS enabled the detection of trace amounts of unconverted cobalamins. Nevertheless, this approach remains restricted by instrument sensitivity and stability as well as the performance of immunoaffinity purification for different vitamers. Further development of a reliable monitoring method is a prerequisite for further optimization of the cyanidation process. However, significant improvements of analytical instrumentation in terms of sensitivity and stability are required to overcome the current limitations. [ABSTRACT FROM AUTHOR]

Gut microbiota and its metabolites, such as short-chain fatty acids (SCFAs) and vitamins, are involved in maintaining energy homeostasis, which is quite relevant in the context of obesity. The aim of this work was to screen the predictive representation of biosynthetic pathways for vitamins and SCFAs based on the data of metagenomic gut microbiome sequencing in patients with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO). The study included two groups: a control group (n = 130) and obese patients (n = 133), with the latter group being further divided into subgroups with MHO (n = 38) and MUHO (n = 55). The predictive representation of metabolic pathways of vitamin and SCFA synthesis in stool samples was studied using the PICRUSt2 software. Obese patients demonstrated an increase in the representation of vitamin B1, B2, B5, B6, B7, B9, and K synthesis pathways, as well as a decrease in the main pathways of vitamin B12 synthesis. Meanwhile, the pattern of changes relied on the metabolic obesity phenotypes. MHO was accompanied by an imbalance in the pathways of B1 synthesis and an increase in the representation of vitamin K synthesis pathways, whereas MUHO led to an increase in the ability of the gut microbiota to produce vitamins B1, B2, B5, B6, B7, B9, and K, as well as to the suppression of B12 biosynthesis. In addition, patients with MUHO showed an increase in the representation of synthesis pathways for such SCFAs as acetate, propanoate and butanoate, which was not observed in MHO patients. Overall, the change in the representation of gut microbiota metabolic pathways in obese patients results from the "selection" of microorganisms under the impact of specific factors, which are more pronounced in MUHO. Thus, an imbalance in gut microbiota biosynthesis pathways of vitamins and SCFAs reflects a disruption of metabolic symbiosis within the macroorganism–microorganism (human–microbiome) superorganism. [ABSTRACT FROM AUTHOR]

Hypochlorite is known to oxidatively degrade the corrin ring of cobalamin. Here, transient reaction intermediates are described in the reaction of aqua as well as of cyano-cobalamin with hypochlorite, using stopped-flow UV–vis kinetics. For aqua-cobalamin, the intermediate is assigned as arising from substitution of the aqua ligand with hypochlorite. For cyano-cobalamin, the intermediate is proposed to arise from substitution of the benzimidazole ligand trans to the cyanide. In both cases, the intermediates would feature a new Co(III)-OCl−bond—which is also supported by density functional theory (DFT) calculations. [ABSTRACT FROM AUTHOR]