Testicular damage by high doses of vitamin B6 (pyridoxine) in rats: a light and electron microscopical study

Male Wistar rats were administered daily intraperitoneal injections of 125, 250, 500, and 1000 mg/kg/day of vitamin B6 for 2 and 6 weeks and the histogenesis of the testicular damage was investigated. A reduction of germ cells was not prominent in the 2-week groups, whereas a delay in spermiation, degeneration of elongated spermatids, and Sertoli cell alterations were observed in the 500- and 1000-mg groups, although generally, these were relatively mild. Ectoplasmic specializations (ES), tubulobulbar complexes, and endoplasmic reticulum (ER) in the apical processes of Sertoli cells were irregularly arranged and their disappearance was also retarded. The Sertoli cell cytoplasm was often retracted and condensed. In the 6-week groups, no histological change in the testis was noted with the 125-mg dose. The retardation in spermiation and Sertoli cell alterations similar to those in the 500-mg dose 2-week group were observed in the 250-mg group. In the 500- and 1000-mg groups, germ cells were generally degenerated and markedly reduced in number. Multinucleate germ cells were mingled with anisocytotic germ cells, and openings of intercellular bridges were occasionally found. Sertoli cells also showed more severe alterations, such as focal disappearance of ES in earlier than ordinary stages, marked dilation of the ER, and markedly condensed or electron-lucent cytoplasm. These results suggest that the Sertoli cell damage may induce diverse germ cell degeneration in which retardation of spermiation occurs first.     

Depression of vitamin B6 levels due to theophylline

Theophylline overdosage can cause life-threatening symptoms, that include seizures and cardiac arrhythmias, and can be fatal. Neither the onset of toxicity nor the severity of symptoms is well predicted by serum theophylline concentrations. Since depressed vitamin B6 plasma levels can occur in patients receiving theophylline, we explored a B6-theophylline interaction in a rabbit model. Administration of theophylline preparations intraperitoneally (aminophylline) or orally (sustained release anhydrous theophylline) resulted in a 47% depression of plasma pyridoxal 5'-phosphate (PLP) levels. The 87% increase in PLP with pyridoxine administration was only 18% when aminophylline was also given. The mechanism of the theophylline-B6 interaction is obscure. Ethylenediamine in some theophylline preparations binds directly to PLP, potentially increasing the less direct theophylline effect. Pyridoxine supplementation resulted in higher average PLP levels but did not prevent death in animals with profoundly low PLP levels. If these data apply to humans, B6 deficiency may contribute to chronic theophylline toxicity; however, pyridoxine administration in the dosage used may not prevent toxicity. Larger doses may prove beneficial after further investigation.     

Anaphylaxis to riboflavin (vitamin B2).

BACKGROUND: Vitamin supplements are used more commonly in normal healthy subjects than in patients with vitamin deficiency. Thiamine (vitamin B,) is the vitamin that most frequently induces allergic reactions. To the best of our knowledge, no case of anaphylaxis to riboflavin (vitamin B2) has thus far been reported in the literature. OBJECTIVE: We describe a previously healthy 15-year-old boy in whom anaphylaxis developed several times after he drank one soft drink or took a single multivitamin tablet. This study was done to determine which of the many components found in the soft drink and vitamin tablet caused the anaphylactic reaction. METHODS: In an outpatient clinic with the availability of complete resuscitative procedures, we performed single-blind prick skin tests and intradermal skin tests on the patient with various pure vitamin components of the soft drink and the multivitamin tablet. Physiologic saline and histamine were used for negative and positive controls, respectively. RESULTS: Riboflavin, a component of both the soft drink and the vitamin tablet, produced positive reactions on intradermal skin tests in the patient. Positive reactions were not present in the normal control subjects. CONCLUSIONS: Riboflavin is a previously unreported cause of anaphylaxis. Free-form riboflavin may potentially be associated with an anaphylactic reaction. It is a vitamin widely used in many patients with chronic disease and in healthy subjects. Vitamin B2 must be considered as a cause of anaphylaxis.     

Pyridoxine neuropathy: Correlation of functional tests and neuropathology in beagle dogs treated with large doses of vitamin B6

Neurologic examination, electrophysiologic testing and microscopic post-mortem examination was used to study the neuropathy induced in the beagle dog by administration of excessive amounts of vitamin B₆.Two female dogs received repeated daily oral doses of 3 g. The treatment was ceased when the dogs developed severe general morbidity, including uncoordinated gait and abnormal neurologic symptoms. The symptoms were most severe during and early after cessation of treatment, and in general they regressed during the subsequent 3 months of treatment-free observation. Sensory central and peripheral maximum nerve conduction velocity started to decrease after a considerable delay; the decrease progressed until late after termination of treatment and failed to fully regress. Morphologic lesions were confined to large, first order sensory neurons.The neurologic examination thus revealed the early changes, while electrodiagnostics and microscopic neuropathology were indicators of more advanced stages of toxic neuropathy and disclosed selective lesions in individuals whose gait appeared to be unremarkable.     

Insight into vitamin B6‐dependent epilepsy due to PLPBP (previously PROSC) missense mutations

Vitamin B₆‐dependent genetic epilepsy was recently associated to mutations in PLPBP (previously PROSC), the human version of the widespread COG0325 gene that encodes TIM‐barrel‐like pyridoxal phosphate (PLP)‐containing proteins of unclear function. We produced recombinantly, purified and characterized human PROSC (called now PLPHP) and its six missense mutants reported in epileptic patients. Normal PLPHP is largely a monomer with PLP bound through a Schiff‐base linkage. The PLP‐targeting antibiotic d ‐cycloserine decreased the PLP‐bound peak as expected for pseudo‐first‐order reaction. The p.Leu175Pro mutation grossly misfolded PLPHP. Mutations p.Arg241Gln and p.Pro87Leu decreased protein solubility and yield of pure PLPHP, but their pure forms were well folded, similarly to pure p.Pro40Leu, p.Tyr69Cys, and p.Arg205Gln mutants (judged from CD spectra). PLPHP stability was decreased in p.Arg241Gln, p.Pro40Leu, and p.Arg205Gln mutants (thermofluor assays). The p.Arg241Gln and p.Tyr69Cys mutants respectively lacked PLP or had a decreased amount of this cofactor. With p.Tyr69Cys there was extensive protein dimerization due to disulfide bridge formation, and PLP accessibility was decreased (judged from d ‐cycloserine reaction). A 3‐D model of human PLPHP allowed rationalizing the effects of most mutations. Overall, the six missense mutations caused ill effects and five of them impaired folding or decreased stability, suggesting the potential of pharmacochaperone‐based therapeutic approaches.     

Treatment of persistent sleep-wake schedule disorders in adolescents with methylcobalamin (vitamin B12).

Two adolescent patients suffering from persistent sleep-wake schedule disorders appear to have responded to treatment with vitamin B12 (methylcobalamin). A 15-year-old girl with delayed sleep phase syndrome (DSPS) and a 17-year-old boy with hypernychthemeral syndrome complained of not being able to attend school despite many trials of medication. The improvement of the sleep-wake rhythm disorders appeared immediately after the administration of high doses (3,000 micrograms/day) of methylcobalamin. Neither patient showed any laboratory or clinical evidence of vitamin B12 deficiency or hypothyroidism (which can cause B12 deficiency). Serum concentrations of vitamin B12 during treatment were in the high range of normal or above normal. The duration of the sleep period of the DSPS patient decreased gradually from 10 hours to 7 hours, and the time of sleep onset advanced from 2 a.m. to midnight. The period of the sleep-wake cycle of the hypernychthemeral patient was 24.6 hours before treatment and 24.0 hours after treatment. The relationship between the circadian basis of these disorders and vitamin B12 and its metabolites is discussed.     

Theoretical involvement of vitamin B6 in tumour initiation

Vitamin B6 is a co-enzyme involved in the biosynthesis of thymidine. Thymidine deficiency has been reported to increase DNA replication errors and hence increase mutagenesis. Carcinogenic stimulae increase the rate of DNA repair, and increase cell multiplication, both of which increase the requirement for thymidine. Vitamin B6 deficiency occurring at the same time as contact with carcinogens could well lead to tumour initiation and subsequent cancer development.     

Gastric adenocarcinoma due to ataxia-telangiectasia (Louis-Bar syndrome).

A 26-year-old male with ataxia-telangiectasia died with a gastric adenocarcinoma. Malignancy is a recognised complication of this condition, the majority of cases being reticuloendothelial. There have been three reports of gastric adenocarcinoma associated with ataxia-telangiectasia; this, however, is the first in British published reports.