original
B6 levels in rheumatoid of treatment1
Vitamin
effect H.
Ralph
Schumacher,2
M.D.,
ABSTRACT
Finn
W.
Patients
phosphate.
Treatment
in pyridoxal
with
with
phosphate
no improvement 1200-1203, 1975.
in
Bernhart,3
50
in most the
rheumatoid cases
clinical
Serum pyridoxal levels have been reported to be decreased in a majority of patients with rheumatoid arthritis as well as in a variety of other diseases (1). Abnormal tryptophan metabolism as manifested by urine kynurenine excretion
after
tryptophan
loading
in patients
with
rheumatoid arthritis can be corrected by treatment with 50 mg pyridoxine (2) whether or not they are strictly pyridoxine deficient (3). Rheumatoid patients (with lower urinary pyridoxine
levels
controls)
have
than
age
matched
healthy
reported to show some decrease in stiffness the day after receiving 10 mg pyridoxine (4). Ellis (5) has reported pyridoxine several tive
been
to types
be effective of
arthritis
hand
and
in the problems
carpal
treatment
of
in degenera-
tunnel
syndrome.
However,
100 mg of pyridoxine over 6 months has been reported not to alter detectably the neuropathy of rheumatoid arthritis (6). Changes in the arthritis were not evaluated in this report. Theoretical
min
mechanisms
B6 deficiency
for
in influencing
a role
of vita-
the course
arthritis were than of
arthritis
include
decreased
ocyte effectiveness (7) and suppression of the immune response (8-10). Since the etiology of rheumatoid arthritis is not understood one can
only
speculate
whether
such
changes
would be beneficial or deleterious. This report describes our documentation lower than, normal levels of plasma pyridoxal
1200
The A merican
Journal
of Clinical
Nutrition
Downloaded from https://academic.oup.com/ajcn/article-abstract/28/11/1200/4732866 by University of Glasgow user on 03 April 2018
Gy#{246}rgy,4 M.D.
found
to
have
low
hydrochloride
for
pretreatment
levels.
arthritis.
plasma
3 months
Am.
There J.
pyridoxal caused
was, Clin.
a rise
however, Nutr.
28:
(PLP) in patients with rheumatoid arthritis. In a group of patients given large supplements of pyridoxine hydrochloride, plasma PLP levels were elevated after 3 months of oral treatment but this did not produce any clinical or laboratory improvement in the arthritis.
Materials
and
methods
Patients fulfilling the American Rheumatism Association criteria for classic or definite rheumatoid arthritis were studied as outpatients at the Hospital of the University of Pennsylvania. Pregnant subjects and those taking any vitamin pills or oral contraceptives were excluded. The diet of all the subjects was normal and adequate. Stable weight was maintained throughout the study. In a preliminary study PLP was determined in 55 patients with rheumatoid arthritis. The group consisted of 19 men and 36 women: the age range was from 20 to 75 years. On the basis of the low levels found in comparison with normal subjects tested at the same time, 21 subjects were systematically studied before and after oral administration of pyridoxine hydrochloride (50 ISO mg/day) or placebo. Patients and examiner (HRS) worked in double-blind manner. Pyridoxine and placebo tablets were identical in appearance and were identified From
the
Department
of
Medicine,
University
of
Pennsylvania School of Medicine and the Department of Pediatric Research, Philadelphia General Hospital, Philadelphia, Pennsylvania 19104. 2Associate Professor of Medicine, University of Pennsylvania School of Medicine. 3Research Biochemist, Philadelphia General Hospital (Deceased).
Active
of
Paul
phosphate
of
phag-
3 times
rheumatoid
1
rheumatoid
and
of pyridoxine
to more
aspects
arthritis:
Ph.D.
150 mg/day
communications
Consultant,
and Professor Pennsylvania.
28: NOV
EM BER
Philadelphia
Emeritus
of
1975,
1200-1203.
pp.
General
Pediatrics,
Hospital
University
Printed
in U.S.A.
of
VITAMIN
000
U 00
B
LEVELS
RHEUMATOID
1201
ARTHRITIS
(‘40
0000
;
+
I.
IN
-‘--U 0.0
&l
I
0. U
I
I
i++Ir++;+l+
I
U
10=
fl0a’OUfl’fl0fs’O’-0 0 0 r= 0
.00
--(‘4--
-
s
r
00
ri -0 -r’4-
r=
0
a’
0
a’
00
a’ -
.0
.
..
E E
u r
a’
f
U
00
r=
4
00
‘i.s
fl
‘fi r-
r-4
r
a’
0000
1
-0
rs
a’
a’
fs
(‘4
‘
B6 levels in rheumatoid of treatment1
Vitamin
effect H.
Ralph
Schumacher,2
M.D.,
ABSTRACT
Finn
W.
Patients
phosphate.
Treatment
in pyridoxal
with
with
phosphate
no improvement 1200-1203, 1975.
in
Bernhart,3
50
in most the
rheumatoid cases
clinical
Serum pyridoxal levels have been reported to be decreased in a majority of patients with rheumatoid arthritis as well as in a variety of other diseases (1). Abnormal tryptophan metabolism as manifested by urine kynurenine excretion
after
tryptophan
loading
in patients
with
rheumatoid arthritis can be corrected by treatment with 50 mg pyridoxine (2) whether or not they are strictly pyridoxine deficient (3). Rheumatoid patients (with lower urinary pyridoxine
levels
controls)
have
than
age
matched
healthy
reported to show some decrease in stiffness the day after receiving 10 mg pyridoxine (4). Ellis (5) has reported pyridoxine several tive
been
to types
be effective of
arthritis
hand
and
in the problems
carpal
treatment
of
in degenera-
tunnel
syndrome.
However,
100 mg of pyridoxine over 6 months has been reported not to alter detectably the neuropathy of rheumatoid arthritis (6). Changes in the arthritis were not evaluated in this report. Theoretical
min
mechanisms
B6 deficiency
for
in influencing
a role
of vita-
the course
arthritis were than of
arthritis
include
decreased
ocyte effectiveness (7) and suppression of the immune response (8-10). Since the etiology of rheumatoid arthritis is not understood one can
only
speculate
whether
such
changes
would be beneficial or deleterious. This report describes our documentation lower than, normal levels of plasma pyridoxal
1200
The A merican
Journal
of Clinical
Nutrition
Downloaded from https://academic.oup.com/ajcn/article-abstract/28/11/1200/4732866 by University of Glasgow user on 03 April 2018
Gy#{246}rgy,4 M.D.
found
to
have
low
hydrochloride
for
pretreatment
levels.
arthritis.
plasma
3 months
Am.
There J.
pyridoxal caused
was, Clin.
a rise
however, Nutr.
28:
(PLP) in patients with rheumatoid arthritis. In a group of patients given large supplements of pyridoxine hydrochloride, plasma PLP levels were elevated after 3 months of oral treatment but this did not produce any clinical or laboratory improvement in the arthritis.
Materials
and
methods
Patients fulfilling the American Rheumatism Association criteria for classic or definite rheumatoid arthritis were studied as outpatients at the Hospital of the University of Pennsylvania. Pregnant subjects and those taking any vitamin pills or oral contraceptives were excluded. The diet of all the subjects was normal and adequate. Stable weight was maintained throughout the study. In a preliminary study PLP was determined in 55 patients with rheumatoid arthritis. The group consisted of 19 men and 36 women: the age range was from 20 to 75 years. On the basis of the low levels found in comparison with normal subjects tested at the same time, 21 subjects were systematically studied before and after oral administration of pyridoxine hydrochloride (50 ISO mg/day) or placebo. Patients and examiner (HRS) worked in double-blind manner. Pyridoxine and placebo tablets were identical in appearance and were identified From
the
Department
of
Medicine,
University
of
Pennsylvania School of Medicine and the Department of Pediatric Research, Philadelphia General Hospital, Philadelphia, Pennsylvania 19104. 2Associate Professor of Medicine, University of Pennsylvania School of Medicine. 3Research Biochemist, Philadelphia General Hospital (Deceased).
Active
of
Paul
phosphate
of
phag-
3 times
rheumatoid
1
rheumatoid
and
of pyridoxine
to more
aspects
arthritis:
Ph.D.
150 mg/day
communications
Consultant,
and Professor Pennsylvania.
28: NOV
EM BER
Philadelphia
Emeritus
of
1975,
1200-1203.
pp.
General
Pediatrics,
Hospital
University
Printed
in U.S.A.
of
VITAMIN
000
U 00
B
LEVELS
RHEUMATOID
1201
ARTHRITIS
(‘40
0000
;
+
I.
IN
-‘--U 0.0
&l
I
0. U
I
I
i++Ir++;+l+
I
U
10=
fl0a’OUfl’fl0fs’O’-0 0 0 r= 0
.00
--(‘4--
-
s
r
00
ri -0 -r’4-
r=
0
a’
0
a’
00
a’ -
.0
.
..
E E
u r
a’
f
U
00
r=
4
00
‘i.s
fl
‘fi r-
r-4
r
a’
0000
1
-0
rs
a’
a’
fs
(‘4
‘
