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Journal of Gastroenterology Mar 2023The Japanese diagnostic criteria for autoimmune gastritis (AIG) were established by the "Study Group on the establishment of diagnostic criteria for type A gastritis,"...
The Japanese diagnostic criteria for autoimmune gastritis (AIG) were established by the "Study Group on the establishment of diagnostic criteria for type A gastritis," which is related to a workshop associated with the Japan Gastroenterological Endoscopy Society (JGES) and the Committee of AIG Research Group (CARP). The criteria were set as follows: the cases of confirmed diagnosis are patients in whom either the endoscopic or histological findings, or both, meet the requirements for AIG and who are confirmed to be positive for gastric autoantibodies (either anti-parietal cell or anti-intrinsic factor antibodies, or both). The presentation of endoscopic findings of early-stage AIG in the diagnostic criteria was withheld owing to the need for further accumulation and characterization of endoscopic clinical data. Therefore, diagnosis of early-stage AIG only requires histological confirmation and gastric autoantibody positivity. Suspected cases are patients in whom either the endoscopic or histological findings, or both, meet only the requirements for AIG. Histological findings only meet the requirements for early stage. AIG has been underdiagnosed in the past, but our study group's newly proposed diagnostic criteria will enable a more accurate and early diagnosis of AIG. The criteria can be used to stratify patients into various high-risk groups for gastric tumors and pernicious anemia. They would allow the establishment of an appropriate surveillance system in the coming years. Nevertheless, issues such as establishing the endoscopic findings of early-stage AIG and obtaining Japanese insurance coverage for gastric autoantibody tests require attention.
Topics: Humans; Autoimmune Diseases; Japan; Gastritis; Autoantibodies; Endoscopy
PubMed: 36855000
DOI: 10.1007/s00535-022-01954-9 -
International Journal of Molecular... Apr 2022Dysregulation of one-carbon metabolism affects a wide range of biological processes and is associated with a number of diseases, including cardiovascular disease,... (Review)
Review
Dysregulation of one-carbon metabolism affects a wide range of biological processes and is associated with a number of diseases, including cardiovascular disease, dementia, neural tube defects, and cancer. Accumulating evidence suggests that one-carbon metabolism plays an important role in COVID-19. The symptoms of long COVID-19 are similar to those presented by subjects suffering from vitamin B deficiency (pernicious anemia). The metabolism of a cell infected by the SARS-CoV-2 virus is reshaped to fulfill the need for massive viral RNA synthesis, which requires de novo purine biosynthesis involving folate and one-carbon metabolism. Many aspects of host sulfur amino acid metabolism, particularly glutathione metabolism underlying antioxidant defenses, are also taken over by the SARS-CoV-2 virus. The purpose of this review is to summarize recent findings related to one-carbon metabolism and sulfur metabolites in COVID-19 and discuss how they inform strategies to combat the disease.
Topics: COVID-19; Carbon; Folic Acid; Homocysteine; Humans; Methionine; SARS-CoV-2; Vitamin B 12; Post-Acute COVID-19 Syndrome
PubMed: 35456998
DOI: 10.3390/ijms23084181 -
Human Molecular Genetics Aug 2022Autoimmune thyroid disease (AITD) and pernicious anemia (PA) often coexist, but the directionality is unknown. In a two-sample Mendelian randomization (MR) analysis,...
Autoimmune thyroid disease (AITD) and pernicious anemia (PA) often coexist, but the directionality is unknown. In a two-sample Mendelian randomization (MR) analysis, using summary statistics from large genome-wide association studies (GWASs) in Europeans (N = 49 269-755 406), we examined the genetic associations between thyroid function, PA and markers of erythropoiesis. We performed inverse variance weighted random-effects MR, several sensitivity MR analyses, and bidirectional MR and MR Steiger for directionality. AITD and PA were associated bidirectionally (P ≤ 8 × 10-6). Neither euthyroid thyroid stimulating hormone (TSH) nor free thyroxine (FT4) were causally associated with PA. One standard deviation (SD) increase in euthyroid FT4 regulated by genetic variants in deiodinases 1 and 2 genes (DIO1/DIO2), corresponding to low-normal free triiodothyronine (FT3) levels, was causally associated with a pernicious/macrocytic anemia pattern, i.e. decreased erythrocyte counts (rank-based inverse normal transformed β = -0,064 [95% confidence interval: -0,085, -0,044], P = 8 × 10-10) and hemoglobin (-0.028 [-0.051, -0.005], P = 0.02) and increased mean corpuscular hemoglobin (0.058 [0.025, 0.091], P = 5 × 10-4) and mean corpuscular volume levels (0.075 [0.052, 0.098], P = 1 × 10-8). Meanwhile, subclinical hyperthyroidism mirrored that pattern. AITD was causally associated with increased erythrocyte distribution width (P = 0.007) and decreased reticulocyte counts (P ≤ 0.02), whereas high-normal FT4 regulated by DIO1/DIO2 variants was causally associated with decreased bilirubin (-0.039 (-0.064, -0.013), P = 0.003). In conclusion, the bidirectional association between AITD and PA suggests a shared heritability for these two autoimmune diseases. AITD was causally associated with impaired erythropoiesis and not autoimmune hemolysis. Additionally, in euthyroid individuals, local regulation of thyroid hormones by deiodinases likely plays a role in erythropoiesis.
Topics: Anemia, Pernicious; Erythropoiesis; Genome-Wide Association Study; Humans; Mendelian Randomization Analysis; Thyroid Gland; Thyrotropin; Thyroxine
PubMed: 35225327
DOI: 10.1093/hmg/ddac052 -
Clinical Toxicology (Philadelphia, Pa.) Feb 2020The clinical consequences of excess vitamin B induced by multiple oral doses of cyanocobalamin are not well-known. A young woman was treated with multiple daily doses...
The clinical consequences of excess vitamin B induced by multiple oral doses of cyanocobalamin are not well-known. A young woman was treated with multiple daily doses of 1 mg of cyanocobalamin for severe pernicious anemia. After a total dose of 12 mg, she developed acne, palpitations, anxiety, akathisia, facial ruddiness, headache, and insomnia. She improved two weeks after stopping the drug. There were no sequelae nor complications. Although these symptoms of cobalamin toxicity were unexpected and unusual, the case reminds us that the administration of any drug is not entirely safe.
Topics: Acne Vulgaris; Adult; Anemia, Pernicious; Anxiety; Dose-Response Relationship, Drug; Female; Humans; Injections, Intramuscular; Treatment Outcome; Vitamin B 12
PubMed: 31018715
DOI: 10.1080/15563650.2019.1606432 -
BMJ (Clinical Research Ed.) Apr 2020
Topics: Anemia, Pernicious; Attention; Erythrocyte Indices; Fatigue; Humans; Hydroxocobalamin; Injections, Intramuscular; Missed Diagnosis; Peripheral Nervous System Diseases; Vitamin B 12 Deficiency; Vitamin B Complex
PubMed: 32332011
DOI: 10.1136/bmj.m1319 -
Nestle Nutrition Institute Workshop... 2020Vitamin B12 is a fascinating nutrient in that it is made by microbes but is essential for human metabolism. Humans can get it only from animal origin foods. Dietary... (Review)
Review
Vitamin B12 is a fascinating nutrient in that it is made by microbes but is essential for human metabolism. Humans can get it only from animal origin foods. Dietary deficiency rather than an absorption defect (Pernicious anemia, intrinsic factor defect) is the commonest cause of deficiency in the world, contributed by cultural and economic imperatives. Indians have a large prevalence of subclinical B12 deficiency due to vegetarianism. Birth cohort with long-term serial follow-up (Pune Maternal Nutrition Study) has helped reveal the life-course evolution of B12 deficiency: genetics, transplacental and lactational transfer from the mother, influence of family environment, rapid childhood and adolescent growth, and low consumption of milk all made a contribution. A novel association of low maternal B12 status was with fetal growth restriction and increased risk factors of diabetes in the baby. After demonstrating adequate absorption of small (2 μg) dose of vitamin B12, and a noticeable improvement of metabolic parameters in a pilot trial, we planned a supplementation trial in adolescents to improve outcomes in their babies (a primordial prevention called Pune Rural Intervention in the Young Adolescent). The results are awaited. The long-term effects in the babies born in the trial will contribute to a better understanding of the Developmental Origins of Health and Disease.
Topics: Adolescent; Adult; Animals; Diet; Diet, Vegetarian; Dietary Supplements; Female; Folic Acid; Folic Acid Deficiency; Gastrointestinal Microbiome; Humans; India; Male; Pregnancy; Vitamin B 12; Vitamin B 12 Deficiency
PubMed: 31991435
DOI: 10.1159/000503358