Association with Vitamin

The first commercial synthesis of a vitamin occurred ia 1933 when the Reichsteia approach was employed to manufacture vitamin C (6). AH 13 vitamins ate available ia commercial quantities, and their biological functions have largely been estabUshed (7). A Hst of Nobel prize winners associated with vitamin research is given ia Table 2. 

Disease States. Rickets is the most common disease associated with vitamin D deficiency. Many other disease states have been shown to be related to vitamin D. These can iavolve a lack of the vitamin, deficient synthesis of the metaboUtes from the vitamin, deficient control mechanisms, or defective organ receptors. The control of calcium and phosphoms is essential ia the maintenance of normal cellular biochemistry, eg, muscle contraction, nerve conduction, and enzyme function. The vitamin D metaboUtes also have a function ia cell proliferation. They iateract with other factors and receptors to regulate gene transcription. 

Angular cheilitis presents with small cracking lesions, erythema, and soreness at the corners of the mouth associated with vitamin and iron deficiency... 

Chronic use of resins may be associated with increased bleeding tendency due to hypoprothrombinemia associated with vitamin K deficiency. 

Cobalt (Co) Inhalation exposure "hard metal" pneumoconiosis Alloy in metals - but also associated with vitamin Bq2... 

Cobalt in small amounts is an essential element associated with vitamin B12, but at high levels can be toxic. There are no daily recommended intake levels for cobalt. Intestinal bacteria use cobalt to produce cobalamin, which in turn is an essential component of vitamin B12. Industrially, cobalt is used in pigments, permanent magnets, and as an alloy to harden metals as in tungsten carbide blades or drills. 

We found that supplementation of vitamin A in the form of an aerosol is an effective, safe, and routinely manageable method to enhance vitamin A and RBP concentrations. Consequently, this modality of treatment may serve as an alternative vitamin A therapy during chronic or acute episodes of malnutrition, malabsorption, or in case of insufficient compliance to other therapies and might be useful in respiratory diseases associated with vitamin A deficiency. 

Cyanocobalamin, or vitamin B12, is in small amounts required for red blood cell production and for the formation of nucleoproteins and proteins. It is also needed for the proper functioning of the nervous system. Folic acid supplements can correct the anemia associated with vitamin B12 deflciency. Unfortunately, folic acid will not correct changes in the nervous system that result from vitamin B12 deficiency. Vitamin B12 is only found in animal sources such as liver and other organs. Some vitamin B12 is obtained from fish, eggs and milk. Folic acid and cyanocobalamin have been discussed in more detail in Chapter 22. 

D. There is no evidence that affinity for D3 with its receptor is altered during aging. Aging is associated with vitamin D deficiency for several reasons. It is important for the elderly to receive vitamin D supplementation to prevent osteoporosis and the other problems associated with hypocalcemia. If they have chronic liver or renal conditions, use of one of the specific metabolites should be used, such as cal-citriol. 

IM therapy should be reserved for patients with GI, liver, or biliary disease associated with vitamin D malabsorption... 

Vitamin B12 is used to treat or prevent deficiency. The most characteristic clinical manifestation of vitamin B12 deficiency is megaloblastic, macrocytic anemia (Table 33-2), often with associated mild or moderate leukopenia or thrombocytopenia (or both), and a characteristic hypercellular bone marrow with an accumulation of megaloblastic erythroid and other precursor cells. The neurologic syndrome associated with vitamin Bi2 deficiency usually begins with paresthesias in... 

Other classes of enzyme included in Table 5 are the pyridoxal phosphate enzymes and those associated with vitamin B12. 

Electroencephalographic abnormalities associated with vitamin B therapy have been reported (SEDA-15, 412 18). Tingling of the fingertips, faintness, and dizziness have been observed. Peripheral neuropathy has been reported (19). Tingling in the orofacial region has been attributed to a neuropathic effect, but this could have been due to vasodilatation. 

Aloe extract, used in association with vitamin E and squalene, is also able to cause regression of any tumor already formed in a mouse skin model. 

IWHS+ 7 yr 34,486 F Reduction of risk of death for coronary heart disease, the activity was determined by vitamin E not taken as a supplement no activity was associated with vitamin A and C (147,198)... 

Protovitamin-A material, usually a dimer, that can be cleaved to produce one or more materials exhibiting biological activity associated with vitamins. 

Clinical Conditions Associated with Vitamin B12 Deficiency. 185... 

Se 50-200 /zg Glutathione peroxidase Associated with vitamin E metabolism may be considered to be a nonmetal... 

The discovery, isolation and final synthesis of a whole group of new compounds essential to health in a balanced diet was another triumph of the chemist. These compounds called vitamins A, Ba or G, C, D, E, K, and several others closely associated with vitamin Ba, such as niacin, pantothenic acid, inositol, para-amino benzoic acid, choline, pyndoxine (Be), biotin (H), folic acid and Bn, prevent deficiency diseases such as xerophthalmia (an eye disease), beriberi, pellagra, scurvy, rickets, sterility (in rats), excessive bleeding and so forth. Professors Elmer V. McCollum and Herbert M. Evans, and Joseph Goldberger were among the early American pioneers in this field of research. Drugs, anaesthetics, and medicines like procaine, cyclopropane, dramamme, ephedrine, aspirin, phenace-tin, urotropin, veronal, quinine, and strychnine have been synthesized to alleviate the pains of mankind. The essential... 

A small number of patients show one or the other of the biochemical signs associated with vitamin Be deficiency despite apparendy adequate status, and require high intakes of the vitamin to normalize the abnormal metabolic marker. These are genetic diseases and have been termed vitamin Be dependency syndromes. 

In patients suffering from a wide variety of tmrelated diseases, including Hodgkins lymphoma, rheumatoid arthritis, schizophrenia, porphyria, renal tuberculosis and aplastic anemia, there is abnormal excretion of kynurenine metabolites after a test dose of tryptophan (Altman and Greengard, 1966 Coon and Nagler, 1969). It is unlikely that such disparate conditions would aU be associated with vitamin Be deficiency. Liver biopsy shows elevated tryptophan... 

Both hydroxylation reactions in the synthesis of carnitine from trimethyllysine are ascorbic acid-dependent, 2-oxoglutarate-linked, reactions (Section 13.3.3), and impaired synthesis of carnitine probably accounts for the muscle fatigue associated with vitamin C deficiency. 

No major disease states have been found to be associated with vitamin E deficiency due to adequate levels in the average diet. 

Since vitamin E is absorbed from the intestines in chylomicrons, any fat malabsorption diseases can lead to deficiencies in vitamin E intake. Neurological disorders have been associated with vitamin E deficiencies associated with fat malabsorptive disorders. 

It acts as a cofactor for glycogen phosphorylase in glycogenolysis. Decreased glucose tolerance may be associated with vitamin B-6 deficiency. 

Neurological complications also are associated with vitamin B-12 deficiency and result from a progressive demyelination of nerve cells. The demyelination is thought to result from the increase in methylmalonyl-CoA that result from vitamin B-12 deficiency. Methylmalonyl-CoA is a competitive inhibitor of malonyl-CoA in fatty acid biosynthesis as well as being able to substitute for malonyl-CoA in any fatty acid biosynthesis that may occur. Since the myelin sheath is in continual flux the methylmalonyl-CoA-induced inhibition of fatty acid synthesis results in the eventual destruction of the sheath. The incorporation methylmalonyl-CoA into fatty acid biosynthesis results in branched-chain fatty acids being produced that may severely alter the architecture of the normal membrane structure of nerve cells... 

Corrigan JJ Jr, Marcus FI. Coagulopathy associated with vitamin E ingestion. JAMA 1974 230(9) 1300-1. 

---