Vitamin Beriberi

In this period, the empirical healing of certain diseases by foods was estabUshed. Examples (3) were the treatment of night blindness (vitamin A deficiency) with hver ia many cultures over centuries, of beriberi (vitamin deficiency) by use of unpoHshed rice by the Japanese navy, of scurvy (vitamin C deficiency) by citms fmits ia the British navy or piae needle extracts by North American natives, and pellagra (niacia deficiency) by a dietary shift away from corn-based foods ia many countries. Other, nondietary empirical treatments iavolved, eg, exposure of children ia northern latitudes to sunlight to cute tickets (vitamin D deficiency) (4). 

In this period, the empirical healing of certain diseases by foods was established. Examples (3) were the treatment of night blindness (vitamin A deficiency) with liver in many cultures over centuries, of beriberi (vitamin deficiency) by use of unpolished rice by the Japanese navy, of scurvy (vitamin C... 

It was found that oryzanin corresponded to the beriberi vitamin (vitamin Bi) reported by C. Funk (1884—1967), and actually the report of oryzanin had appeared earlier than that of beriberi vitamin, whereas only the name of vitamin Bjand the achievement of Funk are recognized at present (Chapter 11.2). 

Jansen, B., Donath, W. Isolation of anti-beriberi vitamin. Med. dienst d. volksgenzondh. in Nederl. Indie 1, 190 (1927)... 

Another ten years were to elapse before Funk gave the name of vitamine to the substance whose absence from foodstuffs was responsible for the development of polyneuritis . Later the term vitamin(e) was applied to the whole group of organic compounds, small amounts of which are essential to the health of man and beast. The various vitamins were distinguished by prefixes or subscripts, and later still by giving them names from which the word vitamin had disappeared completely. As years went by, the substance connected with polyneuritis has been called vitamine, vitamine B, vitamin Bi, oryzanin, toruline, antineuritic vitamin, anti-beriberi vitamin... 

Our word vitamin was coined m 1912 m the belief that the substances present m the diet that prevented scurvy pellagra beriberi rickets and other diseases were vital amines In many cases that belief was confirmed certain vitamins did prove to be amines In many other cases however vitamins were not amines Nevertheless the name vitamin entered our language and stands as a reminder that early chemists recognized the crucial place occupied by amines m biological processes... 

Beriberi, Thiamine Deficiency. The recognition of vitamins and their importance to the health of human beings came about when Eijkman, a Dutch pathologist, was sent to Java in an attempt to cure an epidemic of beriberi that had appeared in one of the hospitals. Eijkman kept a flock of chickens on the hospital grounds to assist in discovering the disease agent he assumed was involved in the etiology of beriberi. These chickens were fed the scraps from the plates of the hospital patients—primarily poHshed rice, the common food in that part of the world (11). 

Thiamine, whose structure is shown in Figure 18.17, is known as vitamin Bj and is essential for the prevention of beriberi, a nervous system disease that has occurred in the Far East for centuries and has resulted in considerable sickness and death in these countries. (As recently as 1958, it was the fourth leading cause of death in the Philippine Islands.) It was shown in 1882 by the director-general of the medical department of the Japanese nayt that beriberi could be prevented by dietary modifications. Ten years later, Christiaan Eijkman, a Dutch medical scientist working in Java, began research that eventually showed that thiamine was the... 

The water-soluble vitamins comprise the B complex and vitamin C and function as enzyme cofactors. Fofic acid acts as a carrier of one-carbon units. Deficiency of a single vitamin of the B complex is rare, since poor diets are most often associated with multiple deficiency states. Nevertheless, specific syndromes are characteristic of deficiencies of individual vitamins, eg, beriberi (thiamin) cheilosis, glossitis, seborrhea (riboflavin) pellagra (niacin) peripheral neuritis (pyridoxine) megaloblastic anemia, methyhnalonic aciduria, and pernicious anemia (vitamin Bjj) and megaloblastic anemia (folic acid). Vitamin C deficiency leads to scurvy. 

F6. Funk, C., Studies on beriberi. Chemistry of the vitamin fraction from yeast and rice polishings. J. Physiol. 46, 173-179 (1913). 

Vitamin Bi, or thiamine, is a precursor to thiamine pyrophosphate, an essential coenzyme for several enzymes. Beriberi is a vitamin Bi deficiency disease. 

Thiamine (vitamin Bi), in the form of thiamine diphosphate (TPP), is a coenzyme of some considerable importance in carbohydrate metabolism. Dietary deficiency leads to the condition beriberi, characterized by neurological disorders, loss of appetite, fatigue, and muscular weakness. We shall study a number of... 

Vitamin deficiency of Bj leads to the disease known as Beriberi. However, nowadays in the Western hemisphere, vitamin Bj deficiency is mainly found as a consequence of extreme alcoholism. In fact, the vitamin absorption by the gut is decreased and its excretion is increased by alcohol. Alcohol also inhibits the activation of vitamin Bj to its coenzyme form, thiamine pyrophosphate ester (TPP). There is no evidence of adverse effects of oral intake of thiamine [417]. The main food sources of vitamin Bj are lean pork, legumes, and cereal grains (germ fraction). It is soluble in water and stable at higher temperature and at pH lower than 5.0, but it is destroyed rapidly by boiling at pH 7.0 or above. 

Inadequate nutrition and conditions which are complicated by malabsorption may lead to thiamine deficiency. Beriberi, a diet-deficiency disease, is especially prevalent in those parts of the East where the diet consists mainly of polished rice. The disease is characterized by neuritis but may also lead to serious heart failure. Recovery is prompt when adequate amounts of vitamin B1 are restored to the diet. Severe deficiency as can occur in alcoholics may lead to Wernicke s encephalopathy, often accompanied by Korsakoff s syndrome. Care should be taken with intravenous substitution with thiamine in these cases to prevent serious complications like vascular collapse with hypotension, respiratory distress or an-gioedema. 

Severe thiamine vitamin Bf) deficiency results in beriberi. The symptoms can include growth retardation, muscular weakness, apathy, edema, and heart failure. Neurological symptoms, such as personality changes and mental deterioration, also may be present in severe cases. Because of the role played by thiamine in metabolic processes in all cells, a mild deficiency may occur when energy needs are increased. Since thiamine is widely distributed in food, beriberi is rare except in communities existing on a single staple cereal food. The disease does occur with some frequency in alcoholics, whose poor diet may lead to an inadequate daily intake of thiamine. 

Answer The symptoms resemble those you remember from medical school for beriberi, but you fail to see the coimection. Then a light clicks on. If the patient were consuming most of his calories as alcohol, he may have a nutritional deficiency, a beriberi-Uke syndrome, as a result of insufficient intake of thiamine. You prescribe a daily vitamin tablet and admonish the patient to cut back on alcohol intake. At the next appointment, the edema is much better and the cardiac stress tests results are normal. He has joined Alcohohcs Anonymous and indicates that he is doing better. 

Vitamin Bj deficiency, known as beriberi, was historically seen primarily in people of southeast Asia, for dietary reasons. The symptoms of beriberi are neurological disorders (weakness, paralysis, painful neuritis), diarrhea, loss of appetite, dermatitis, and anemia. These symptoms are due mainly to the accumulation of pyruvate and lactate. 

Deficiency symptoms In severe vitamin B deficiency beriberi develops. 

The pyruvate decarboxylase reaction provides our first encounter with thiamine pyrophosphate (TPP) (Fig. 14-13), a coenzyme derived from vitamin B Lack of vitamin Bi in the human diet leads to the condition known as beriberi, characterized by an accumulation of body fluids (swelling), pain, paralysis, and ultimately death. 

TAs one might predict, mutations in the genes for the subunits of the PDH complex, or a dietaiy thiamine deficiency, can have severe consequences. Thiamine-deficient animals are unable to oxidize pyruvate normally. This is of particular importance to the brain, which usually obtains all its energy from the aerobic oxidation of glucose in a pathway that necessarily includes the oxidation of pyruvate. Beriberi, a disease that results from thiamine deficiency, is characterized by loss of neural function. This disease occurs primarily in populations that rely on a diet consisting mainly of white (polished) rice, which lacks the hulls in which most of the thiamine of rice is found. People who habitually consume large amounts of alcohol can also develop thiamine deficiency, because much of their dietaiy intake consists of the vitamin-free empty calories of distilled spirits. An elevated level of pyruvate in the blood is often an indicator of defects in pyruvate oxidation due to one of these causes. ... 

Til. Role of the Vitamin Thiamine People with beriberi, a disease caused by thiamine deficiency, have elevated levels of blood pyruvate and a-ketoglutarate, especially after consuming a meal rich in glucose. How are these effects related to a deficiency of thiamine ... 

Vitamin B1 (thiamine) has the active form, thiamine pyrophosphate. It is a cofactor of enzymes catalyzing the conversion of pyruvate to acetyl CoA, a-ketoglutarate to succinyl CoA, and the transketolase reactions in the pentose phosphate pathway. A deficiency of thiamine causes beriberi, with symptoms of tachycardia, vomiting, and convulsions. In Wernicke-Korsakoff syndrome (most common in alcoholics), individuals suffer from apa thy, loss of memory, and eye movements. There is no known toxicity for this vitamin. 

Nearly all the water-soluble vitamins are heterocyclic compounds. Among the first to be isolated was thiamine (vitamin Bi) (62), deficiency of which causes degenerative changes in the nervous system, including the multiple peripheral neuritis characteristic of beriberi. Thiamine deficiency can arise from decomposition of the vitamin by bacteria in the gut. In mammalian metabolism the hydroxy group of thiamine is esterified to give cocarboxylase (thiamine pyrophosphate) which catalyzes the decarboxylation of a-keto acids to aldehydes, acyloins or acids, and their transformation into acyl phosphates. 

FUNK, CAS1M.IR 11884-1948). Bom in Poland and later becoming an American citizen. Funk in 1911 isolated a food factor, extracted from rice hulls, that he found to he a cure for a disease caused bv malnutrition (beriberi). Believing this to be an amine compound essential to life, he coined the name vilamine, from which the final e was later dropped. The various Ivpcs and functions of vitamins were not differentiated until some years later as a result of the work of McCollum, Szent-Gyorgi, R.J. Williams, and others. 

In one form of thiamine deficiency, Wernicke s syndrome may be noted. Therein is paralysis, or weakness of the muscles that causes motion of the eyeball. Oosely associated with thiamine deficiency are dietary problems of alcoholism. The psychotic disturbances of alcoholism, including delirium tremens, frequently respond to thiamine and other B complex vitamins. Injections of thiamine often produce dramatic improvements in persons suffering from beriberi. Beriberi sometimes occurs in infants who are breast-fed by mothers who suffer a thiamine deficiency. Beriberi remains of concern in the Orient where polished rice is a dietary staple. 

Water-Soluble Vitamins Thiamine (B,) Precursor of the coenzyme thiamine pyrophosphate. Deficiency can cause beriberi. 

Vitamin B, [thiamin) Men 1.2 mg/d Women 1.1 mg/d Coenzyme in the metabolism of carbohydrates and certain amino acids prevents beriberi No adverse effects have been reported ... 

---