Efficacy of short‐term oral cobalamin therapy for the treatment of cobalamin deficiencies related to food‐cobalamin malabsorption: A study of 30 patients

Background: It has been suggested that oral cobalamin (vitamin B₁₂) therapy may be an effective therapy for treating cobalamin deficiencies related to food‐cobalamin malabsorption. However, the duration of this treatment was not determined. Patients and method: In an open‐label, nonplacebo study, we studied 30 patients with established cobalamin deficiency related to food‐cobalamin malabsorption, who received between 250 and 1000 μg of oral crystalline cyanocobalamin per day for at least 1 month. Endpoints: Blood counts, serum cobalamin and homocysteine levels were determined at baseline and during the first month of treatment. Results: During the first month of treatment, 87% of the patients normalized their serum cobalamin levels; 100% increased their serum cobalamin levels (mean increase, +167 pg/dl; P < 0.001 compared with baseline); 100% had evidence of medullary regeneration; 100% corrected their initial macrocytosis; and 54% corrected their anemia. All patients had increased hemoglobin levels (mean increase, +0.6 g/dl) and reticulocyte counts (mean increase, +35 × 10⁶/l) and decreased erythrocyte cell volume (mean decrease, 3 fl; all P < 0.05). Conclusion: Our findings suggest that crystalline cyanocobalamin, 250–1000 μg /day, given orally for 1 month, may be an effective treatment for cobalamin deficiencies not related to pernicious anemia.     

维生素B12工业生产技术的进展

介绍了维生素B12生产过程中菌株的选育和工艺的优化进展，包括二步发酵工艺和膜反应器的应用与改进。通过菌株选育和工艺改进大大提高了产量，推进了生产。特别是膜技术和其他分离技术的联用弥补了单一膜反应器中原料利用率低的缺点，具有良好的生产应用价值。     

HPLC测定注射用13种复合维生素中维生素H、叶酸及维生素B12含量

 目的建立应用高效液相色谱同时测定注射用水溶性维生素中的维生素H、叶酸及维生素B12含量的方法。方法采用Intersil(ODS-2)C₁₈(4.6mm×150mm,5μm)色谱柱;以0.05mol·L^-1磷酸二氢钾溶液(用磷酸调pH到3.0)-乙腈(10∶90)为流动相;流速为1mL·min^-1;检测波长为210nm;进样量为10μL;柱温为30℃。结果谱图中维生素H、叶酸和维生素B12检测限分别为0.50,1.10和0.82μg·L^-1;维生素H、叶酸和维生素B₁₂分别在9.49～14.23,96.74～145.1和0.746～1.118mg·L^-1内呈线性关系;平均回收率分别为100.96%(RSD=1.72%)、101.77%(RSD=0.14%)和101.27%(RSD=1.71%)。结论该方法简单、快速、灵敏度高、重复性好。     

HPLC测定甲钴胺的有关物质

目的:建立高效液相色谱法(HPLC),测定甲钴胺的有关物质。方法:采用Lichrospher-NH2色谱柱(250 mm × 4.6 mm,5μm),流动相为0.3％磷酸溶液:乙腈(32:68),流速1.0 mL/min,检测波长254 nm。结果:甲钴胺、氰钴胺和羟钴胺的最 低检测限量分别为4.4、2.6和4.0 ng,甲钴胺与各杂质分离良好。结论:该法简便、快速,灵敏度高,准确可靠。     

Strategies for Hepatic Gene Correction

Many different cancer types have previously been found to show increased uptake of the vitamins folate, vitamin B12, and biotin; however, it is not known whether these tumor lines show increased uptake of one or more of the vitamins. The current study was designed to examine the relative uptake of the three vitamins in 10 different types of cell lines. Rhodamine-labeled hydroxypropyl-methacrylamide (HPMA) was targeted with vitamin B₁₂, folate, or biotin, and the uptake of the labeled polymer was compared both in in vitro cell cultures and in mice-bearing tumors from a variety of tumor cell lines. Fluorescent microscopy of cell cultures and histological examination of tumor sections showed greatly increased uptake of the fluorescently labeled polymer in many tumors when the polymer was targeted with folate, biotin, or vitamin B₁₂. Tumors with enhanced uptake of vitamin B₁₂- or folate-targeted rhodamine-HPMA also showed increased uptake of biotin-Rho-HPMA. In contrast, tumors with increased uptake of folate-Rho-HPMA did not show increased uptake of vitamin B12 (VB₁₂)-HPMA and vice versa. These findings suggest that vitamin-targeted polymers may greatly increase the uptake of drug–polymer complexes in certain tumors, which may result in an increased efficacy of antitumor agents, and which may allow for easier imaging of both the primary and metastatic tumors.     

Comparison of the efficacy of parenteral and oral treatment for nutritional vitamin B12 deficiency in children

ABSTRACT

Objective: Although, oral replacement for vitamin B12 deficiency has been proved to be effective in adults, it is mainly treated with parenteral therapy. There are only few studies on oral replacement therapy of vitamin B12 with children. Therefore, we aimed to compare the efficacy of oral treatment with intramuscular vitamin B12 injections in pediatric population.

Methods: Children with serum cobalamin concentrations less than 300?pg/mL, were treated either with the parenteral therapy or with oral vitamin B12. The primary and secondary outcomes of the study were the normalization of serum vitamin B12 and hemoglobin at first month, respectively.

Results: Post-treatment vitamin B12 values were significantly higher than pre-treatment values (p-value <.001). Vitamin B12 increased from 183.5?±?47?pg/mL to 482?±?318.9?pg/mL in the oral and from 175.5?±?42.5?pg/mL to 838?±?547?pg/mL in the parenteral treatment arm (p-value <.001). Before treatment, 82 children had anemia according to age and gender. After treatment, 14/41 and 8/41 patients still had anemia at the first month of treatment in the parenteral and oral arms, respectively. The number of patients who still have anemia at the end of the 1st month of treatment did not significantly changed in the parenteral and oral treatment groups (p-value?=?.44).

Conclusions: In this study, both oral and parenteral formulations were shown to be effective in normalizing vitamin B12 levels. We suggest that oral formulations may be considered to be safe as a first line treatment for vitamin B12 deficiency in children.