Normal pathway of B12 absorption and cellular uptake.

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Presentation transcript:

Normal pathway of B12 absorption and cellular uptake. Normal pathway of B12 absorption and cellular uptake. Food B12 is released in the stomach and binds to salivary HC. In the small intestine, food B12 and biliary B12 are released from HC by pancreatic proteases and bind to intrinsic factor (IF). The IF-B12 complex then binds to the cubam (Cubilin [Cub]–amnionless [Amn]) receptor in the terminal ileum for internalization and release to plasma where it is bound by TC. TC delivers B12 to the TC receptor (CD320) on cells, and following release in the cell, B12 is reduced and converted to adenosylcobalamin in the mitochondria and methylcobalamin in the cytosol, where they serve as cofactors for the 2 B12-dependent reactions. CoA, coenzyme A; THF, tetrahydrofolate. Professional illustration by Patrick Lane, ScEYEnce Studios. Ralph Green Blood 2017;129:2603-2611 ©2017 by American Society of Hematology