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Clinical Studies (Return to Clinical
Studies page)
VITAMIN B-12
(COBALAMIN) IS ESSENTIAL FOR RED BLOOD CELL FORMATION
Moestrup
SK
(2006).
New insights into carrier binding and epithelial uptake of the erythropoietic
nutrients cobalamin and folate. Curr Opin
Hematol. 13(3):119-23.
PURPOSE OF REVIEW: In
addition to malnutrition several genetic and acquired conditions may affect the homeostasis of
cobalamin (vitamin B12) and folate, leading to megaloblastic anemia and other diseases. The
present review describes new insight into protein handling of cobalamin and folate. RECENT
FINDINGS: The recent solution of the three-dimensional structure of the cobalamin binder
transcobalamin shows two separate domains enclosing the vitamin. This structure apparently also
applies for the other homologous cobalamin binders, intrinsic factor and haptocorrin. Genetic
studies of inherited cobalamin malabsorption and biochemical studies have now revealed that the
functional receptor for uptake of intrinsic factor-vitamin cobalamin complexes also is a complex
itself consisting of two different gene products, cubilin and amnionless. A role in folate
uptake of megalin, an endocytic receptor for epithelial uptake of various proteins including
transcobalamin, is now also indicated by the observation that megalin can mediate uptake of
soluble folate receptor. SUMMARY: New data show the structure of cobalamin carriers and reveal
novel proteins involved in the epithelial uptake of cobalamin and folate. Genetic abnormalities
in three different genes encoding proteins in the epithelial uptake of cobalamin are now known
to cause malabsorption of cobalamin and megaloblastic anemia.
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Koury MJ, Ponka P (2004).
New insights into erythropoiesis: the roles of folate, vitamin B12, and iron.
Annu Rev Nutr. 24:105-31.
Erythropoiesis is the process
in which new erythrocytes are produced. These new erythrocytes replace the oldest erythrocytes
(normally about one percent) that are phagocytosed and destroyed each day. Folate, vitamin B12,
and iron have crucial roles in erythropoiesis. Erythroblasts require folate and vitamin B12 for
proliferation during their differentiation. Deficiency of folate or vitamin B12 inhibits purine
and thymidylate syntheses, impairs DNA synthesis, and causes erythroblast apoptosis, resulting
in anemia from ineffective erythropoiesis. Erythroblasts require large amounts of iron for
hemoglobin synthesis. Large amounts of iron are recycled daily with hemoglobin breakdown from
destroyed old erythrocytes. Many recently identified proteins are involved in absorption,
storage, and cellular export of nonheme iron and in erythroblast uptake and utilization of iron.
Erythroblast heme levels regulate uptake of iron and globin synthesis such that iron deficiency
causes anemia by retarded production rates with smaller, less hemoglobinized
erythrocytes.
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