Vitamin B12: The forgotten micronutrient for critical care

Current Opinion in Clinical Nutrition and Metabolic Care

Volumn 13, Issue 6, 2010, Pages 662-668

  Manzanares, William ^a   Hardy, Gil ^b  

^a HOSPITAL DE CLÍNICAS   (Uruguay)

^b MASSEY UNIVERSITY   (New Zealand)

Author keywords

critically ill patients; systemic inflammation; vitamin B12

Indexed keywords

C REACTIVE PROTEIN; CYANOCOBALAMIN; ENDOTHELIAL NITRIC OXIDE SYNTHASE; GLUTATHIONE; IMMUNOGLOBULIN ENHANCER BINDING PROTEIN; INDUCIBLE NITRIC OXIDE SYNTHASE; SYNAPTOTAGMIN I;

ANEMIA; ANTIINFLAMMATORY ACTIVITY; ANTIOXIDANT ACTIVITY; BACTERIOSTASIS; BORDERLINE HYPERTENSION; CHROMATURIA; CONGESTIVE HEART FAILURE; CRITICALLY ILL PATIENT; CYANOCOBALAMIN DEFICIENCY; DIARRHEA; DRUG BLOOD LEVEL; DRUG EFFECT; DRUG MEGADOSE; HUMAN; HYPERSENSITIVITY REACTION; HYPERTENSION; HYPOKALEMIA; INJECTION SITE PAIN; INTENSIVE CARE; INTENSIVE CARE UNIT; LUNG EDEMA; NONHUMAN; OXIDATIVE STRESS; PHAGOCYTOSIS; PROTEIN BLOOD LEVEL; RED URINE; REVIEW; SKIN DISCOLORATION; SYSTEMIC INFLAMMATORY RESPONSE SYNDROME;

ANIMALS; ANTIOXIDANTS; CRITICAL ILLNESS; HUMANS; INFLAMMATION; SEPSIS; VITAMIN B 12;

ANIMALIA;

EID: 78149255992     PISSN: 13631950     EISSN: 14736519     Source Type: Journal    
DOI: 10.1097/MCO.0b013e32833dfaec     Document Type: Review

References (39)

1. Wheatley C. A scarlet pimpernel forthe resolution of inflammation? The role of supra-therapeutic doses of cobalamin, in the treatment of systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, and septic or traumatic shock. Med Hypotheses 2006;67:124-142.
2. Krautler B. Vitamin B12: chemistry and biochemistry. Biochem Soc Trans 2005;33:806-810.
3. Krautler B, Arigoni D, Golding BT, editors. Vitamin B12 and B12-proteins. Weinheim, Germany: Wiley-VCH; 1998.
4. Mahmud K, Ripley D, Swaim WR, et al. Haematologic complications of partial gastrectomy. Ann Surg 1973;177:432-435.
5. Birch CS, Brasch NE, McCaddon A, et al. A novel role for vitamin B12: •• cobalamins are intracellular antioxidants in vitro. Free Radic Biol Med 2009;47:184-188. An excellent experimental study, which demonstrated that cobalamins behave as antioxidants at pharmacological concentrations and afford significant cellular protection against oxidative stress.
6. Yamashiki M, Nishimura A, Kosaka Y. Effects of methylcobalamin (vitamin B12) on in vitro cytokine production of peripheral blood mononuclear cells. J Clin Lab Immunol 1992;37:173-182.
7. Stover PJ. Vitamin B12 and older adults. Curr Opin Clin Nutr Metab Care 2010;13:24-27.
8. Smith AD. Folic acid fortification: the good, the bad and the puzzle of vitamin B12. Am J Clin Nutr 2007;85:3-5.
9. Tal S, Shavit Y, Stern F, et al. Association between vitamin B12 levels and mortality in hospitalized older patients. J Am Geriatr Soc 2010;58:523-526.
10. Corcoran T, O'Neill M, Webb S, et al. Prevalence of vitamin deficiencies on • admission: relationship to hospital mortality in critically ill patients. Anaesth Intensive Care 2009;37:254-260. This cohort study identified that vitamin B12 were significantly higher in nonsurvivors critically ill patients but could not demonstrate an independent association with hospital mortality.
11. Corcoran TB, O'Neill MP, Webb S A R, et al. Inflammation, vitamin deficiencies • and organ failure in critically ill patients. Anaesth Intensive Care 2009;37:740-747. This small clinical study found a weak correlation between vitamins A and B12, with severity of illness evaluated by CRP and SOFA scores suggesting that B12 may be influenced by SIRS.
12. Solomon RS. Disorders of cobalamin (vitamin B12) metabolism: emerging concepts in pathophysiology, diagnosis, and treatment. Blood Rev 2007;21:113-130.
13. Allen LH. How common is vitamin B-12 deficiency? Am J Clin Nutr 2009;89(Suppl): 693S-696S.
14. Woo KS, Kim KE, Park JS, et al. Relationship between the levels of holotranscobalamin and vitamin B12. Korean J Lab Med 2010;30:185-189.
15. Galloway P, McMillan DC, Sattar N. Effect of the inflammatory response on trace element and vitamin status. Ann Clin Biochem 2000;37:289-297.
16. Rodriguez RM, Corwin HL, Gettinger A, et al. Nutritional deficiencies and blunted erythropoietin response as causes of the anemia of critical illness. J Crit Care 2001;16:36-41.
17. Racca V, Castiglioni P, Ripamonti V, et al. Nutrition markers in patients after • heart surgery. JPEN J Parenter Enteral Nutr 2010;34:143-150. A well performed study that show that after heart surgery anaemia improves and high levels of inflammation markers decline. Concomitantly, vitamins remain stable within normal values, with the exception of vitamin B12, which significantly decreases after 16 days. According to this finding, the authors suggest that vitamin B1 2 supplementation should be encouraged during the rehabilitation period after heart surgery.
18. Bateman AP, McArdle F, Walsh TS. Time course of anemia during six months follow up following intensive care discharge and factors associated with impaired recovery of erythropoiesis. Crit Care Med 2009;37:1906-1912.
19. von Ahsen N, Muller C, Serke S, et al. Important role of nondiagnostic blood loss and blunted erythropoietic response in the anemia of medical intensive care patients. Crit Care Med 1999;27:2630-2639.
20. Abilés J, Pérez Abud R, Moratalla G, et al. High prevalence of hyperhomocysteinemia in critically ill patients: vascular damage and adequate vitamin intake. e-SPEN 2008;3: e240-e245.
21. Ploder M, Kurz K, Spittler A, et al. Early increase of plasma homocysteine in sepsis patients with poor outcome. Mol Med 2010; doi: 10.2119/molmed.2010.00008 [Epub ahead of print]
22. Wheatley C. The return of the Scarlet Pimpernel: cobalamin in inflammation II - cobalamins can both selectively promote all three nitric oxide synthases (NOS), particularly iNOS and eNOS, and, as needed, selectively inhibit iNOS and nNOS. J Nutr Environ Med 2007;16:181-211.
23. Scalabrino G, Carpo M, Bamonti F, et al. High tumor necrosis factor-a in level in cerebrospinal fluid of cobalamin-deficient patients. Ann Neurol 2004;56:886-890.
24. Scalabrino G. Vitamin-regulated cytokines and growth factors in the CNS and elsewhere. J Neurochem 2009;111:1309-1326.
25. Veber D, Mutti E, Tacchini L, et al. Indirect down-regulation of nuclear NF-kappa B levels by cobalamin in the spinal cord and liver of the rat. J Neurosci Res 2008;86:1380-1387.
26. Weinberg JB, Chen Y, Jiang N, et al. Inhibition of nitric oxide synthase •• by cobalamins and cobinamides. Free Radic Biol Med 2009;46:1626-1632. This very interesting and elegant experimental study was the first that showed inhibition of isoforms of NOS and nitric oxide production by cobalamin and cobinamides, suggesting that these agents could be useful as pharmacological tools in humans with inflammatory states and nitric oxide overproduction such as severe sepsis.
27. Wheatley C. Cobalamin in inflammation III: glutathionylcobalamin and methylcobalamin/adenosylcobalamin coenzymes - the sword in the stone? How cobalamin may directly regulate the nitric oxide synthases. J Nutr Environ Med 2007;16:212-226.
28. Manzanares W, Biestro A, Galusso F, et al. High dose selenium for critically ill patients with systemic inflammation. Pharmacokinetics and pharmacodynamics of selenious acid: a pilot study. Nutrition 2010;26:634-640.
29. Sriram K, Lonchyna VA. Micronutrient supplementation in adult nutrition therapy: practical consideration. JPEN J Parenter Enteral Nutr 2009;33:548-562.
30. Shenkin A. Basics in clinical nutrition: trace elements and vitamins in parenteral and enteral nutrition. e-SPEN 2008;3: e293-e297.
31. Braga M, Ljungqvist O, Soeters P, et al. ESPEN guidelines on parenteral nutrition: surgery. Clin Nutr 2009;28:378-386.
32. Nava-Ocampo AA, Pastrak A, Cruz T, et al. Pharmacokinetics of high doses of cyanocobalamin administered by intravenous injection for 26 weeks in rats. Clin Exp Pharmacol Physiol 2005;32:13-18.
33. Joint Formulary Committee. British National Formulary. Edition 57. London: BMJ Group and RPS Publishing; 2009; p. 508.
34. Borron SW, Baud F, Megarbane B, et al. Hydroxocobalamin for severe acute cyanide poisoning by ingestion or inhalation. Am J Emerg Med 2007;25:551-558.
35. Shepherd G, Velez LI. Role of hydroxocobalamin in acute cyanide. Ann Pharmacother 2008;42:661-669.
36. Uhl W, Nolting A, Galleman D, et al. Changes in blood pressure after administration of hydroxocobalamin: relationship to changes in plasma cobalamins-(III) concentrations in healthy volunteers. Clin Toxicol 2008;46:551-559.
37. Lukaski HC. Vitamin and mineral status: effects on physical performance. Nutrition 2004;20:632-644.
38. Vgeser M, Lorenzl S. Comparison of automated assays forthe determination of vitamin B12 in serum. Clin Biochem 2007;40:1342-1345.
39. Hoey L, Strain JJ, McNulty H. Studies of biomarker responses to intervention with vitamin B-12: a systematic review of randomized controlled trials. Am J Clin Nutr 2009;89(Suppl): 1981S-1996S.