The Biochemical Basis of Cobalamin Deficiency

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Presentation transcript:

The Biochemical Basis of Cobalamin Deficiency AYALEW TEFFERI, M.D., RAJIV K. PRUTHI, M.D. Mayo Clinic Proceedings Volume 69, Issue 2, Pages 181-186 (February 1994) DOI: 10.1016/S0025-6196(12)61046-5 Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 1 Chemical structure of cobalamins. (Modified from Chanarin I. The Megaloblastic Anaemias. 2nd ed. Oxford: Blackwell, 1979. By permission.) Mayo Clinic Proceedings 1994 69, 181-186DOI: (10.1016/S0025-6196(12)61046-5) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 2 A, Cofactor activity of methylcobalamin (CH3-Cbl) in methionine synthesis. THF = tetrahydrofolate. B, Cofactor activity of adenosylcobalamin (Ado-Cbl) in succinyl-coenzyme A (CoA) synthesis. MeMaCoA = methylmalonyl-coenzyme A. Mayo Clinic Proceedings 1994 69, 181-186DOI: (10.1016/S0025-6196(12)61046-5) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 3 Enteric processing and absorption of cobalamin (Cbl). IF = intrinsic factor; R-binder = a cobalophilin with a rapid (compared with IF) electrophoretic mobility; TCii = transcobalamin II. Mayo Clinic Proceedings 1994 69, 181-186DOI: (10.1016/S0025-6196(12)61046-5) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 4 Chemical structure of folic acid. Mayo Clinic Proceedings 1994 69, 181-186DOI: (10.1016/S0025-6196(12)61046-5) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 5 Enteric processing and absorption of folates. Me = methyl; PGA1 and PGAn = pteroylglutamic acid (folic acid)—monoglutamated and polyglutamated forms; THF1 = monoglutamated form of tetrahydrofolate. Mayo Clinic Proceedings 1994 69, 181-186DOI: (10.1016/S0025-6196(12)61046-5) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 6 Intracellular interdependent cofactor activity of cobalamin (Cbl) and folate. CH3 = methyl group; THF1 and THFn = monoglutamated and polyglutamated forms of tetrahydrofolate. Mayo Clinic Proceedings 1994 69, 181-186DOI: (10.1016/S0025-6196(12)61046-5) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions