Folate, measurement

Patients with homozygous sickle cell disease (SS) had a mean serum folate of 5.8 JLg/liter compared with 7.2 p.g/liter in patients with sickle cell trait and 7.9 p.g/liter in healthy controls. However, there was no correlation between the serum folate and the hematocrit or reticulocyte count. Since reticulocytes may have a higher folate concentration than mature erythrocytes, Liu found that the erythrocyte folate, measured before and after removal of the reticulocytes, was a reliable indicator of the folate status in patients with sickle cell disease despite the variable degree of re-ticulocytosis. Using this technique only one of nine patients was found to have a low erythrocyte concentration of the vitamin. Treatment with fohc acid resulted in higher hematocrits in three of four patients with low serum and erythrocyte folate concentrations, but only one of 12 patients with a normal folate concentration showed any improvement when treated with folate. 

Martin, H. Comeskey, D. Folate measurement in mammalian tissues by fluorescence polarization. Pteridines 2011, 22, 105-110. 

Fohc acid is a precursor of several important enzyme cofactors required for the synthesis of nucleic acids (qv) and the metaboHsm of certain amino acids. Fohc acid deficiency results in an inabiUty to produce deoxyribonucleic acid (DNA), ribonucleic acid (RNA), and certain proteins (qv). Megaloblastic anemia is a common symptom of folate deficiency owing to rapid red blood cell turnover and the high metaboHc requirement of hematopoietic tissue. One of the clinical signs of acute folate deficiency includes a red and painhil tongue. Vitamin B 2 folate share a common metaboHc pathway, the methionine synthase reaction. Therefore a differential diagnosis is required to measure foHc acid deficiency because both foHc acid and vitamin B 2 deficiency cause... 

With investigations of phytochemicals and functional foods, the outcome measure is generally going to be a biomarker of disease, such as serum cholesterol level as a marker of heart disease risk, or indicators of bone turnover as markers of osteoporosis risk. Alternatively, markers of exposure may also indicate the benefit from a functional food by demonstrating bioavailability, such as increased serum levels of vitamins or carotenoids. Some components will be measurable in both ways. For instance, effects of a folic acid-fortified food could be measured via decrease in plasma homocysteine levels, or increase in red blood cell folate. 

Lee, R. J. Wang, S. Low, R S., Measurement of endosome pH following folate receptor-mediated endocytosis, Biochim. Biophys. Acta 1312, 237-242 (1996). 

Fig. 6.22. Folate-FRET sensor structure and its application to measure disulfide bond reduction in endosomes. The molecule contains the folate moiety which is recognized by the folate receptor situated at the plasma membrane. This recognition leads to endocytosis and after some time to cleavage of the probe. 

Macrocytic anemias are characterized by increased mean corpuscular volume (110 to 140 fL). One of the earliest and most specific indications of macrocytic anemia is hypersegmented polymorphonuclear leukocytes on the peripheral blood smear. Vitamin B12 and folate concentrations can be measured to differentiate between the two deficiency anemias. A vitamin B12 value of less than 150 pg/mL, together with appropriate peripheral smear and clinical symptoms, is diagnostic of vitamin B12-deficiency anemia. A decreased RBC folate concentration (less than 150 ng/mL) appears to be a better indicator of folate-deficiency anemia than a decreased serum folate concentration (less than 3 ng/mL). 

Recently, radioassay methods have been refined to measure folates in biological samples. These techniques use radioactively labeled folates and competitive protein binding.80 Johnson et al.81 compare this method with traditional microbiological assay with L. casei. 

Two-dimensional heteronuclear ( H- N) nuclear magnetic relaxation studies indicate that the dihydrofolate reductase-folate complex exhibits a diverse range of backbone fluctuations on the time-scale of picoseconds to nanoseconds To assess whether these dynamical features influence Michaelis complex formation, Miller et al used mutagenesis and kinetic measurements to assess the role of a strictly conserved residue, namely Gly-121, which displays large-amplitude backbone motions on the nanosecond time scale. Deletion of Gly-121 dramatically reduces the hydride transfer rate by 550 times there is also a 20-times decrease in NADPH cofactor binding affinity and a 7-fold decrease for NADP+ relative to wild-type. Insertion mutations significantly decreased both... 

P Scheelings. Prospects for measuring folates in Australian foods. Aust J Nutr Diet 53 S23-S28, 1996. 

Some antiepileptic drugs have been associated with low serum and erythrocyte folate concentrations and high total plasma homocysteine concentrations in some patients. The concentrations of folate and homocysteine have been measured in 42 patients taking carbamazepine and 42 matched healthy controls (241). Patients taking carbamazepine had significantly lower serum and erythrocyte folate concentrations. There was hyperhomocystinemia (over 15 gmol/l) in 24% of the patients and 5% of the controls. 

Folic Acid (folate). Chemically, folic acid is a pteryl-glutamic acid. The several forms that occur in nature depend on the numbers of glutamic acid units and methyl groups in the molecules. Because of its usual low concentration, folic acid is generally determined in food materials by the microbiological assay with lactobacillus casei and measured turbidimetrically or titrimetrically. Deficiency of this vitamin could result in... 

Two other measures are commonly taken. Because of profound metabolic acidosis in methanol poisoning, treatment with bicarbonate often is necessary. Since folate-dependent systems are... 

Measurement of blood tHcy is usually performed for one of three reasons (1) to screen for inborn errors of methionine metabolism (2) as an adjunctive test for cobalamin deficiency (3) to aid in the prediction of cardiovascular risk. Hyperhomocysteinemia, defined as an elevated level of tHcy in blood, can be caused by dietary factors such as a deficiency of B vitamins, genetic abnormalities of enzymes involved in homocysteine metabolism, or kidney disease. All of the major metabolic pathways involved in homocysteine metabolism (the methionine cycle, the transsulfuration pathway, and the folate cycle) are active in the kidney. It is not known, however, whether elevation of plasma tHcy in patients with kidney disease is caused by decreased elimination of homocysteine in the kidneys or by an effect of kidney disease on homocysteine metabolism in other tissues. Additional factors that also influence plasma levels of tHcy include diabetes, age, sex, lifestyle, and thyroid disease (Table 21-1). 

Indirect indicators of vitamin B12 deficiency include measurements of the metabolites homocysteine and methylmalonic acid (MMA) in serum and MMA in urine (see the Biochemical Perspectives section). Whereas the serum homocysteine concentration increases during folate or vitamin B12 deficiencies, the serum and urine MMA concentrations increase only in vitamin B12 deficiency. Therefore, MMA determinations can be used to differentiate vitamin B12 deficiency from folate deficiency. The normal concentration of MMA in serum ranges from 0.08 to 0.28 pmol/L. MMA is quantified using gas-liquid chromatography and mass spectrometry. Elevated concentrations of MMA and homocysteine in serum may precede the development of hematological abnormalities and reductions in serum vitamin B12 concentrations. One should be aware that other conditions, including renal in sufficiency and inborn errors of metabolism, can also result in elevated serum levels of MMA. 

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