Patients With Metabolic Antagonists None Vitamin Riboflavin

FAT SOLUBLE Vitamin

Other names

Active form

Function

Deficiency

Vitamin A

Retinol, retinal, retinoic acid, βcarotene

Retinol, retinal, retinoic acid

Retinoic acid: development during embryogenesis, maintenance of reproduction, differentiation of epithelial cells, gene expression, immune function – wound healing (& retinol) 11-cis-retinal: vision

Night blindness; retardation of growth, impotence, abnormal epithelial cells, keratinization of skin and cornea, abnormal immune function, xerothalmia/keratom alacia

Cholecalciferol D3 – animals Ergocalciferol D2 – plants UV light converts 7dehydrocholest erol intermediate  cholecalciferol

1,25dihydroxycholecalc iferol (1,25 – diOHD3)

Calcium and phosphorous uptake; regulation of genes involved in the immune system & epithelial cell function; regulation of Ist hydroxylated in hormone levels liver at position 25 Ca2+ needed P needed nd and 2 in kidney at for for position 1 by P450 Bone/tooth Bone/toot hydroxylases structure h Muscle structure contraction Signal Signal transducti transduction on Activate Active vit: proteins/enzy PLP, mes NADPH, nucleic acids

Osteoporosis (tx: vit D and Ca) Children – Rickets (tx vit D) Adults osteomalacia

Medione,

Newborns

Preforme d: egg, milk, fortified cereal Pro vit A: dark colored fruit and vegetabl es Vitamin D

Vitamin

Family of

Co-factor for post-

Signs/Sympt oms Extra Info All-trans retinoic acid and 9-cisretinoic acid complex to RAR and RXR t regulate gene expression through RARE’s

Toxicity

↑ plasma Ca ↓PTH ↓1,25dOHD3 ↓release of Ca from bones

YES Diarrhea, dermatitis, headache nausea

YES Blurred vision, headache, hair loss, scaly skin, liver enlargeme nt, birth defects

↓Plasma Ca ↑PTH ↑1,25diOHD 3 ↑release of Ca from bones ↓ P in plasma ↑1,25diOHD 3 ↑ P in blood ↓1,25diOHD 3 Warfarina nd

Rare

K

polyisoprenoid menaquinone, substituted phyllinquinon napthylquinone s *produced by intestinal bacteria

translational modification of coagulation factors γ-carboxylation of glutamate residue at Nterminal end of factors II, VII, IX, and IX

Prolonged bleeding and easy brusing

Dicoumarol inhibit recycling of Vit K by epoxide reductase

Scurvy: sore bleeding gums, loose teeth, poor wound healing

None

Beri beri: opthamoplegia, foot drop, mental confusion Wet beri beri: pitting edema and acute cardiac symptoms

None

Thiamine is converted to active form by thiamine kinase, requires ATP

Only seen in treatment of patients with metabolic antagonists

None

coA forms a high energy thiolester bond with acyl compound s

Rare: photophobia,

None

Vitamin E Vitamin C

Ascorbic acid

Ascorbic acid

Vitamin B1

Thiamine

Thiamine pyrophosphate (TPP)

Vitamin B5

Pantothenic acid

Coenzyme A

WATER SOLUBLE Antioxidant Co-factor for hydroxylation reactions: collagen synthesis (proline hydroxylase, lysyl hydroxylase); tyrosine degradation (phydroxyphenylpyruvate dioxygenase); catecholamine synthesis (dopamine-β-hydroxylase) Co-factor of enzymes Pyruvateacetly co A by PDH αKGsuccinyl coA by αketoacid dehydrogenase ribose 5P/xyulose 5P sedoheptulose 7P/glyceraldehydes 3P by branched chain α-ketoacid dehydrogenase Acyl carrier protein

Vitamin

Riboflavin

FMN, FAD (both

Electron transfer

B2 Niacin

can accept 1 or 2 e-) Nicotinic acid Nicotinamide

Biotin

Vitamin B6

Folic acid

Pyridoxine Pyridoxamine Pyridoxal

FAD+ coenzyme of dehydrogenases and oxidases Electron transfer Dehydrogenases/reductases NADPH: required by glutathione reductase, cytochrome P450, NAPDH oxidase -biosynthesis of fatty acids, steroids, amino acids, and nucleotides

dermatitis, angular stomatitis, glossitis (slick tongue) Pellagra: 3D’s – dermatitis, diarrhea, dementia (death)

Enzyme bound biotin (bound to εamino group of lysines on proteins)

Carrier of CO2 Carboxylation reaction

Rare – ingestion of raw egg whites, long term antibiotics, total parenteral nutrition,

Pyridoxal phosphate (PLP)

Co-factor for enzymes – especially in amino acid metabolism Aminotranferases, decarboxylases, er/thr dehydratase, thr aldolase, cystathionase, cystathione synthase Transfer of 1C units, synthesis of methionine, purines, and thymine

Rare – glossitis, neuropathy

NAD+, NADP+

Tetrahydrofolic acid

Neural tube defects ↑incidence of cancer ↑homocysteine  ↑heart disease and macrocytic anemia

none

Synthesis of NAD from tryptophan is inefficient & requires vit B6, thiamine, & riboflavin

Muscle pain, fatigue, dermatitis, anorexia, nausea, depression, glossitis, alopecia

Anemia Birth defects

Folate deficiency can be induced by anticancer drugs aminopteri n, methotrex ate  inhibits

Vitamin B12

cobalamine

Methyl cobalamine Deoxyadenosyl colbalamine

Co-factor for reactions: methionine synthase, methylmalonyl coA mutase

Macrocytic anemia Neurological disorders due to progressive demyelination

folate reductase Cobalt in corrin ring