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Transactions. Medico-Chirurgical... 1921
PubMed: 29583549
DOI: No ID Found -
Public Health Nutrition Jun 2021Pellagra is a nutritional deficiency disease associated with niacin (vitamin B3) deficiency. The history of pellagra is well documented for Europe and the USA, but less... (Review)
Review
OBJECTIVE
Pellagra is a nutritional deficiency disease associated with niacin (vitamin B3) deficiency. The history of pellagra is well documented for Europe and the USA, but less is known about the prevalence in sub-Saharan African countries. This study documents the history of pellagra in South Africa, as diagnosed based on dermatological symptoms.
DESIGN
Scoping review of information from scientific databases, library archives, other archives and record services and from Statistics South Africa.
SETTING
South Africa, 1897-2019.
PARTICIPANTS
South African.
RESULTS
Pellagra was first officially recorded in South Africa in 1906, but there are earlier indications of the disease. The prevalence of pellagra peaked after it was all but eradicated in the USA and Europe. Pellagra was never as prevalent in South Africa as in Europe, the USA and Egypt, where special hospitals for pellagrins were established. However, studies on urinary excretion of metabolites conducted in 1960s and 1970s suggested a high prevalence of subclinical (sub-pellagra) niacin deficiency, especially in previously disadvantaged Black populations. As in Europe and the USA, pellagra was associated with poverty and an overdependence on maize as staple food. Malnutrition was the main cause of the disease, but alcohol abuse might have been a contributing factor. In South Africa, reports of pellagra had declined by the late 1980s/early 1990s and hardly any cases were reported by the year 2000.
CONCLUSIONS
Although pellagra, diagnosed based on dermatological symptoms, appears to be largely eradicated in South Africa, it does not rule out the potential for subclinical niacin deficiency.
Topics: Europe; Humans; Niacin; Pellagra; Poverty; South Africa
PubMed: 33769244
DOI: 10.1017/S1368980021001336 -
Indian Journal of Dermatology Jan 2008A 10 year old girl presented with clinical signs and symptoms of the triad of niacin deficiency namely skin eruptions, ataxia, mental changes and diarrhea. Although this...
A 10 year old girl presented with clinical signs and symptoms of the triad of niacin deficiency namely skin eruptions, ataxia, mental changes and diarrhea. Although this deficiency could be nutritional where maize is a staple diet, this patient had neutral aminoaciduria which indicated a defective transport of neutral amino acid transporter in the kidneys and intestine resulting in failure of transport of tryptophan and other neutral (ie, monoaminomonocarboxylic) alpha-amino acids in the small intestine and the renal tubules.
PubMed: 19967017
DOI: 10.4103/0019-5154.39740 -
Advances in Clinical Neuroscience &... 2020Pellagra has largely been forgotten. This is unfortunate as important lessons are to be learnt for the diseases and social consequences of poverty (and of affluence)...
Pellagra has largely been forgotten. This is unfortunate as important lessons are to be learnt for the diseases and social consequences of poverty (and of affluence) that often involve dietary nicotinamide and nicotinamide adenine dinucleotide (NAD) homeostasis. NAD disruption can occur not only from poor diet but from increased consumption of NAD from genotoxic and other stresses. High doses of nicotinamide lead to inhibition of NAD-consuming enzymes and excessive induction of nicotinamide-n-methyl transferase (NNMT) with consequent effects on the methylome giving a mechanism for a new hypervitaminosis-B3.
PubMed: 38125674
DOI: 10.47795/FBFD9966 -
International Journal of Tryptophan... 2019Good health and rapid progress depend on an optimal dose of nicotinamide. Too little meat triggers the neurodegenerative condition pellagra and tolerance of symbionts... (Review)
Review
Good health and rapid progress depend on an optimal dose of nicotinamide. Too little meat triggers the neurodegenerative condition pellagra and tolerance of symbionts such as tuberculosis (TB), risking dysbioses and impaired resistance to acute infections. Nicotinamide deficiency is an overlooked diagnosis in poor cereal-dependant economies masquerading as 'environmental enteropathy' or physical and cognitive stunting. Too much meat (and supplements) may precipitate immune intolerance and autoimmune and allergic disease, with relative infertility and longevity, via the tryptophan-nicotinamide pathway. This switch favours a dearth of regulatory T (Treg) and an excess of T helper cells. High nicotinamide intake is implicated in cancer and Parkinson's disease. Pro-fertility genes, evolved to counteract high-nicotinamide-induced infertility, may now be risk factors for degenerative disease. Moderation of the dose of nicotinamide could prevent some common diseases and personalised doses at times of stress or, depending on genetic background or age, may treat some other conditions.
PubMed: 31320805
DOI: 10.1177/1178646919855940 -
Nutrients Jun 2023The oxidized form of nicotinamide adenine dinucleotide (NAD+) is a critical metabolite for living cells. NAD+ may act either as a cofactor for many cellular reactions as... (Review)
Review
The oxidized form of nicotinamide adenine dinucleotide (NAD+) is a critical metabolite for living cells. NAD+ may act either as a cofactor for many cellular reactions as well as a coenzyme for different NAD+-consuming enzymes involved in the physiological homeostasis of different organs and systems. In mammals, NAD+ is synthesized from either tryptophan or other vitamin B3 intermediates that act as NAD+ precursors. Recent research suggests that NAD+ precursors play a crucial role in maintaining the integrity of the gut barrier. Indeed, its deficiency has been associated with enhanced gut inflammation and leakage, and dysbiosis. Conversely, NAD+-increasing therapies may confer protection against intestinal inflammation in experimental conditions and human patients, with accumulating evidence indicating that such favorable effects could be, at least in part, mediated by concomitant changes in the composition of intestinal microbiota. However, the mechanisms by which NAD+-based treatments affect the microbiota are still poorly understood. In this context, we have focused specifically on the impact of NAD+ deficiency on intestinal inflammation and dysbiosis in animal and human models. We have further explored the relationship between NAD+ and improved host intestinal metabolism and immunity and the composition of microbiota in vivo. Overall, this comprehensive review aims to provide a new perspective on the effect of NAD+-increasing strategies on host intestinal physiology.
Topics: Animals; Humans; Gastrointestinal Microbiome; NAD; Dysbiosis; Niacinamide; Inflammation; Mammals
PubMed: 37447318
DOI: 10.3390/nu15132992 -
Advances in Nutrition (Bethesda, Md.) Jan 2015Fortification is the process of adding nutrients or non-nutrient bioactive components to edible products (e.g., food, food constituents, or supplements). Fortification... (Review)
Review
Fortification is the process of adding nutrients or non-nutrient bioactive components to edible products (e.g., food, food constituents, or supplements). Fortification can be used to correct or prevent widespread nutrient intake shortfalls and associated deficiencies, to balance the total nutrient profile of a diet, to restore nutrients lost in processing, or to appeal to consumers looking to supplement their diet. Food fortification could be considered as a public health strategy to enhance nutrient intakes of a population. Over the past century, fortification has been effective at reducing the risk of nutrient deficiency diseases such as beriberi, goiter, pellagra, and rickets. However, the world today is very different from when fortification emerged in the 1920s. Although early fortification programs were designed to eliminate deficiency diseases, current fortification programs are based on low dietary intakes rather than a diagnosable condition. Moving forward, we must be diligent in our approach to achieving effective and responsible fortification practices and policies, including responsible marketing of fortified products. Fortification must be applied prudently, its effects monitored diligently, and the public informed effectively about its benefits through consumer education efforts. Clear lines of authority for establishing fortification guidelines should be developed and should take into account changing population demographics, changes in the food supply, and advances in technology. This article is a summary of a symposium presented at the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2014 on current issues involving fortification focusing primarily on the United States and Canada and recommendations for the development of responsible fortification practices to ensure their safety and effectiveness.
Topics: Canada; Deficiency Diseases; Diet; Food, Fortified; Health; Humans; Micronutrients; United States
PubMed: 25593151
DOI: 10.3945/an.114.007443 -
Actas Dermo-sifiliograficas Jan 2012In the developed world, pellagra is a rare condition that is restricted to a small number of at-risk groups. It mainly affects alcoholic patients and those with dietary... (Review)
Review
BACKGROUND AND OBJECTIVES
In the developed world, pellagra is a rare condition that is restricted to a small number of at-risk groups. It mainly affects alcoholic patients and those with dietary deficiencies, with intestinal malabsorption, or in treatment with certain drugs. The aim of this study was to analyze the clinical, histopathological, and epidemiological characteristics of patients diagnosed with pellagra in our hospital and to compare the results with the findings traditionally described for this disease.
PATIENTS AND METHODS
We undertook a retrospective study of patients with clinical or pathological evidence of pellagra who were seen in our hospital between 1998 and 2009.
RESULTS
Seven patients met the inclusion criteria. All were men and the most common predisposing factors were alcoholism and dietary deficiency. All exhibited photosensitivity mainly affecting the forearms and the upper surface of the feet, where the lesions were more severe. The most consistent histopathological findings were the presence of dilated blood vessels with extravasation and little or no inflammatory infiltrate. Various changes were observed in the epidermis, including those suggestive of mild pellagra, such as epidermal pallor and some degree of ballooning of the keratinocytes. Other abnormalities such as epidermal necrosis and hyperkeratosis were also observed. In most patients, pellagra was not initially suspected. Additional noncutaneous findings were observed in almost all cases.
CONCLUSIONS
Pellagra should be ruled out in patients with lesions on sun-exposed areas. Predisposing factors for pellagra should be assessed along with the social situation of patients and the presence of digestive or neurological abnormalities.
Topics: Adult; Aged; Alcoholism; Biopsy; Comorbidity; Diagnostic Errors; Epidermis; Humans; Keratinocytes; Keratosis; Male; Malnutrition; Middle Aged; Pellagra; Retrospective Studies; Risk Factors; Social Isolation; Spain; Vasodilation
PubMed: 22456595
DOI: 10.1016/j.adengl.2011.05.003 -
Texas Medical Journal (Austin, Tex.) Jun 1916
PubMed: 36957110
DOI: No ID Found -
Nihon Rinsho Men'eki Gakkai Kaishi =... 2015Niacin, also known as vitamin B3, is required for the synthesis of coenzymes, nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate... (Review)
Review
Niacin, also known as vitamin B3, is required for the synthesis of coenzymes, nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP). Niacin binds with G protein-coupled receptor (GPR) 109A on cutaneous Langerhans cells and causes vasodilation with flushing in head and neck area. Niacin deficiency due to excessive alcohol consumption, certain drugs or inadequate uptake in diet causes pellagra, a photosensitivity dermatitis. Recently several studies have revealed the mechanism of photosensitivity in niacin deficiency, which may pave a way for new therapeutic approaches. The expression level of prostaglandin E synthase (PTGES) is up-regulated in the skin of both pellagra patients and niacin deficient pellagra mouse models. In addition, pellagra is mediated through prostaglandin E₂-EP4 (PGE₂-EP4) signaling via reactive oxygen species (ROS) production in keratinocytes. In this article, we have reviewed the role of niacin in immunity and the mechanism of niacin deficiency-induced photosensitivity.
Topics: Animals; Dinoprostone; Humans; Intramolecular Oxidoreductases; Keratinocytes; Langerhans Cells; Mice; Niacin; Pellagra; Prostaglandin-E Synthases; Reactive Oxygen Species; Receptors, G-Protein-Coupled; Receptors, Prostaglandin E, EP4 Subtype; Signal Transduction; Skin; Up-Regulation; Vasodilation
PubMed: 25765687
DOI: 10.2177/jsci.38.37