Serum pyridoxal in patients with rheumatoid arthritis.

Sanderson, C.; Davis, Richard E.; Bayliss, C. E.

doi:10.1136/ard.35.2.177

Cited by 12 publications

(6 citation statements)

References 11 publications

(9 reference statements)

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“…Patients with rheumatoid arthritis present decreased plasma pyridoxal levels which may or may not be related to the effect of salycilate on tryptophan metabolism (12).…”

Section: Discussionmentioning

confidence: 99%

Rheumatoid arthritis and cataract surgery

Cotlier

1980

Int Ophthalmol

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The prevalence of patients with adult onset rheumatoid arthritis among populations undergoing cataract surgery is low. Only 0.7% of 982 cataract surgery patients in the 45-79 age group, had rheumatoid arthritis. From the prevalence of rheumatoid arthritis in the U.S.A., 12.5% of women and 5.6% of men in the 45-79 age group should have undergone cataract surgery. The lower prevalence of cataracts among rheumatoid arthritis patients may be due to a slower progression of cataracts or to medications (such as acetyl salicylic acid) received for therapy. Acetyl salicylic acid which lowers blood tryptophan may delay or prevent the formation of senile cataracts.

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“…Patients with rheumatoid arthritis present decreased plasma pyridoxal levels which may or may not be related to the effect of salycilate on tryptophan metabolism (12).…”

Section: Discussionmentioning

confidence: 99%

Rheumatoid arthritis and cataract surgery

Cotlier

1980

Int Ophthalmol

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“…Abnormal vitamin B6 metabolism has been reported in rheumatoid arthritis for decades [ 3 , 7 , 8 , 25 , 26 ]. Considering the close associations between vitamin B6 indices and the clinical and biochemical inflammatory markers [ 5 ], it is likely that inflammation causes vitamin B6 deficiency, yet it is also possible that impaired vitamin B6 status contributes to more severe inflammation in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with rheumatoid arthritis have reduced circulating levels of vitamin B6 compared to healthy subjects [ 1 - 3 ]. We have demonstrated that low plasma pyridoxal 5'-phosphate levels reflect the impaired functional vitamin B6 status in these patients.…”

Section: Introductionmentioning

confidence: 99%

Pyridoxine supplementation corrects vitamin B6 deficiency but does not improve inflammation in patients with rheumatoid arthritis

Chiang¹,

Selhub

Bagley

et al. 2005

Arthritis Res Ther

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Patients with rheumatoid arthritis have subnormal vitamin B6 status, both quantitatively and functionally. Abnormal vitamin B6 status in rheumatoid arthritis has been associated with spontaneous tumor necrosis factor (TNF)-α production and markers of inflammation, including C-reactive protein and erythrocyte sedimentation rate. Impaired vitamin B6 status could be a result of inflammation, and these patients may have higher demand for vitamin B6. The aim of this study was to determine if daily supplementation with 50 mg of pyridoxine for 30 days can correct the static and/or the functional abnormalities of vitamin B6 status seen in patients with rheumatoid arthritis, and further investigate if pyridoxine supplementation has any effects on the pro-inflammatory cytokine TNF-α or IL-6 production of arthritis. This was a double-blinded, placebo-controlled study involving patients with rheumatoid arthritis with plasma pyridoxal 5'-phosphate below the 25th percentile of the Framingham Heart Cohort Study. Vitamin B6 status was assessed via plasma and erythrocyte pyridoxal 5'-phosphate concentrations, the erythrocyte aspartate aminotransferase activity coefficient (αEAST), net homocysteine increase in response to a methionine load test (ΔtHcy), and 24 h urinary xanthurenic acid (XA) excretion in response to a tryptophan load test. Urinary 4-pyridoxic acid (4-PA) was measured to examine the impact of pyridoxine treatment on vitamin B6 excretion in these patients. Pro-inflammatory cytokine (TNF-α and IL-6) production, C-reactive protein levels and the erythrocyte sedimentation rate before and after supplementation were also examined. Pyridoxine supplementation significantly improved plasma and erythrocyte pyridoxal 5'-phosphate concentrations, erythrocyte αEAST, urinary 4-PA, and XA excretion. These improvements were apparent regardless of baseline B6 levels. Pyridoxine supplementation also showed a trend (p < 0.09) towards a reduction in post-methionine load ΔtHcy. Supplementation did not affect pro-inflammatory cytokine production. Although pyridoxine supplementation did not suppress pro-inflammatory cytokine production in patients with rheumatoid arthritis, the suboptimal vitamin B6 status seen in rheumatoid arthritis can be corrected by 50 mg pyridoxine supplementation for 30 days. Data from the present study suggest that patients with rheumatoid arthritis may have higher requirements for vitamin B6 than those in a normal healthy population.

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“…Low plasma vitamin B-6 status affects metabolism through the kynurenine pathway in cardiovascular patients with systemic inflammation (17). Abnormal vitamin B-6 status in rheumatoid arthritis has been recognized for decades, but the cause remains to be established (13)(14)(15)18). Reduced amounts of vitamin B-6 confer increased risk of atherosclerosis in humans (19), and vitamin B-6 deficiency induced arteriosclerotic lesions in an animal model (20).…”

Section: Introductionmentioning

confidence: 99%

“…Poor vitamin B-6 status leads to numerous adverse consequences because of its crucial role in the human body. Vitamin B-6 deficiency is often present in humans who suffer from rheumatoid arthritis and other inflammatory conditions (13)(14)(15). In patients with rheumatoid arthritis, the concentration of PLP is associated with multiple markers of inflammation, including disease activity and severity, synovial burden, and pain (14).…”

Section: Introductionmentioning

confidence: 99%

Clinical use of cyclooxygenase inhibitors impairs vitamin B-6 metabolism

Chang¹,

Tang²,

Chen³

et al. 2013

The American Journal of Clinical Nutrition

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Background: A low circulating vitamin B-6 concentration, which is an independent risk factor for cardiovascular disease, is commonly seen in human inflammation. Objective: We investigated whether cyclooxygenase inhibitors alter vitamin B-6 metabolism. Design: To investigate whether subjects taking a cyclooxygenase inhibitor had an altered vitamin B-6 profile, we conducted a crosssectional study that involved 150 rheumatoid arthritis patients, with and without cyclooxygenase inhibitor treatments. C57BL/6J mice and hyperlipidemic Syrian hamsters received drug regimens that reflected clinical nonsteroidal antiinflammatory drug (NSAID) uses in treating human inflammation. The impact of long-term physiologic use of selective and nonselective cyclooxygenase inhibitors on vitamin B-6 metabolism was systematically investigated in these independent in vivo models. Results: Patients who were taking cyclooxygenase inhibitors had lower circulating pyridoxal-5#-phosphate, especially those taking NSAIDs .6 mo. Long-term celecoxib and naproxen use reduced hepatic pyridoxal-5#-phosphate in mice. Nonselective cyclooxygenase inhibitor naproxen significantly decreased vitamin B-6 vitamers in the kidney. Conclusions: To our knowledge, we show novel findings that longterm physiologic doses of cyclooxygenase inhibitor may impede the synthesis of the coenzymatically active form of vitamin B-6. Because the cause of vitamin B-6 depletion in inflammation remains unknown, this study provides a potential mechanism that could account for the poor vitamin B-6 status in human inflammation. Moreover, this study further raises concerns about the long-term clinical use of antiinflammatory NSAIDs in humans. Vitamin B-6 status should be carefully monitored in long-term NSAID users. Future randomized placebo-controlled studies are needed to determine the impacts of antiinflammatory cyclooxygenase inhibitor use on vitamin B-6 metabolism in humans. This trial was registered at clinicaltrials.gov as NCT00944866.Am J Clin Nutr 2013;98:1440-9.

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Serum pyridoxal in patients with rheumatoid arthritis.

Cited by 12 publications

References 11 publications

Rheumatoid arthritis and cataract surgery

Rheumatoid arthritis and cataract surgery

Pyridoxine supplementation corrects vitamin B6 deficiency but does not improve inflammation in patients with rheumatoid arthritis

Clinical use of cyclooxygenase inhibitors impairs vitamin B-6 metabolism

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