Pantothenic Liver disease

Although pantothenic acid deficiency is unknown in humans, the effect of the vitamin has been studied in various pathological conditions, such as hypercholesterolemia, diabetes, and liver disease. Hypercholesterolemia or hyperlipemia does not occur in pantothenic acid deficiency when blood lipids are increased by the injection of Triton-X-100. The administration of j -biphenylbutyric acid alleviates both hypercholesterolemia and hyperlipemia. 

Pantothenic acid excretion and concentration are altered in liver disease. Patients with liver injury excrete less pantothenic acid than normal individuals, and the amount of pantothenic acid excreted correlates with a given liver function test in which pantothenic acid or coenzyme A is known to play a role. Pantothenic acid concentration is reduced in regenerating liver. 

When excess pantothenic acid is administered to diabetic rats, the excretion of sugar and ketone bodies is markedly reduced, and cholesterol accumulates in the liver, adrenals, and blood. Therefore, pantothenic acid administration to diabetic rats appears to stimulate the use of acetate and acetoacetate for cholesterol and fatty acid synthesis. The role of coenzyme A in diabetes is discussed in greater detail in the chapter devoted to that disease. 

Experimental pyridoxine deficiency causes dental caries as well as atherosclerosis. Dental caries increase as a result of civilization and availability of refined and preserved food in general (see Scott, 1956). Wartime circumstances reduced dental caries (Toverud, 1956, 1957) as well as death from coronary sclerotic diseases and the incidence of toxemia of pregnancy. Cirrhosis of the liver has been mentioned also as a sequel of pyridoxine deficiency. The role of a deficiency of lipotropic factors such as choline, methionine, inositol, etc., in this respect has been known for a much longer time. Feeding of vitamin Bu can make the symptoms of atherosclerosis much worse (Annand, 1957). Pantothenic acid deficiency results in a lowering of the cholesterol level in man (Bean el al., 1955). 

It is known that homopantothenic acid improves the metabohsm of glucose in the brain and the higher functions of the brain and it has been used in Japan to enhance mental functions, especially in Alzheimer s disease. A rare side-effect is an abnormal brain function resulting from the failure of the liver to eliminate toxins (hepatic encephalopathy). This condition was reversed by pantothenic acid supplementation, suggesting that it was due to pantothenic acid deficiency caused by the antagonist homopantothenic acid. 

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