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      Metabolism of Mycotoxins, Intracellular Functions of Vitamin B 12, and Neurological Manifestations in Patients with Chronic Toxigenic Mold Exposures. A Review

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          Abstract

          This paper evaluates the possible reasons for consistent vitamin B 12 deficiency in chronic toxigenic mold exposures and the synergistic relationships with the possible mycotoxic effects on one-carbon metabolism that lead to the manifestations of clinical neuropathological symptomology. Vitamins are first defined in general and the nutritional sources of vitamin B 12 are evaluated in particular. Since patients with chronic exposures to toxigenic molds manifest vitamin B 12 deficiencies, the role of mycotoxins in vitamin B 12 metabolism is assessed, and since vitamin B 12 plays important biochemical roles in one-carbon metabolism, the synergistic effects with mycotoxins on humans are reviewed. An outline of the proposed mechanism by which mycotoxins disrupt or interfere with the normal functions of vitamin B 12 on one-carbon metabolism is proposed. The overall functions of vitamin B 12 as a source of coenzymes, in intracellular recycling of methionine, in methionine synthase reaction, in the prevention of chromosome breakage, in methylation, and in maintaining a one-carbon metabolic balance are reviewed. Signs, symptoms, and clinical neurological indications of vitamin B 12 deficiency are also cited. By implication and derivation, it is likely that the interruption of the structure and function of vitamin B 12 would in turn interfere with the one-carbon metabolism leading to the neurological manifestations. This review is an attempt to formulate a basis for an ongoing research investigation on the subject.

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          Nutritional factors and oral candidosis.

          A variety of nutritional factors including deficiencies of iron, folic acid, vitamins, and diets rich in carbohydrates have been implicated in the pathogenesis of oral candidal infections. The following reviews the growing body of data, from in vivo and in vitro studies, related to each of these implicated factors. Although much disagreement exists as to the specific roles played by these individual factors, there is little doubt that nutritional factors either acting locally or via systemic mechanisms could significantly affect the pathogenesis of oral candidoses. Hence, the role of these less well-characterised predisposing factors should be considered when one is treating patients with intractable oral candidal infections.
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            A critical assessment of some biomarker approaches linked with dietary intake.

            In this review many examples are given of the complexities involved in using some biomarkers in relation to assessing the effects of dietary exposure, when there is frequently a need to determine changes following long-term low level exposure to dietary components. These range from understanding why the biomarker might be valuable and how best it can be measured, to the pitfalls which can occur in the interpretation of data. Analytical technique is considered in relation to folate and selenium, and flavonoid and carotenoid species are used to illustrate how the metabolism of a compound may alter the validity or adequacy of a marker. Vitamin A is discussed in relation to the difficulties which can arise when there are several biomarkers that may be available to assess exposure to one nutrient. Vitamin B12 is discussed in relation to the dietary choices made by individuals. Possible interactions and the role of measuring total antioxidant capacity is considered in some detail. In contrast to most nutrients, there is a marked lack of biomarkers of either exposure or effect for most non-nutrients. The role of biological effect monitoring is considered for dietary contaminants, fumonisins and polyhalogenated aromatic hydrocarbons. Aflatoxins are discussed to exemplify food contaminants for which the biomarker approach has been extensively studied. Finally some compounds which are deliberately added to foods and some which appear as processing contaminants are each considered briefly in relation to the requirement for a biomarker of exposure to be developed.
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              Haematological abnormalities in oral lichen planus, candidiasis, leukoplakia and non-specific stomatitis.

              A series of 322 patients presenting with non-ulcerative conditions of the oral mucosa was examined for haematological abnormalities. The series was divided into 5 major groups--lichen planus (103 patients), candidiasis (50), leukoplakia (30), stomatitis or glossitis (66), and a miscellaneous group (73). The prevalence of anaemia, and deficiences in iron, folate and vitamin B12 in each group were compared with that found in 100 controls. The prevalence of anaemia in the series as a whole was not significantly increased, but the prevalences of sideropenia (14.0%), folate deficiency (4.7%) and vitamin B12 deficiency (3.1%) were increased as compared with controls. The prevalence of a haematological abnormality was increased in patients with lichen planus (18/103 p less than 0.05), stomatitis (15/66 p less than 0.01) and particularly in patients with Candidiasis (18/50 p less than 0.001). In the stomatitis group, approximately 45% of the male patients were found to have some haematological deficiency compared with less than 20% of the female patients. The increased prevalence of haematological deficiences suggests that patients presenting with non-ulcerative conditions of the oral mucosa (particularly candidiasis and non-specific stomatitis) should be screened haematologically and that, in some patients with candidiasis, haematological deficiencies may predispose towards candidal infection.
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                Author and article information

                Journal
                ScientificWorldJournal
                ScientificWorldJournal
                TSWJ
                The Scientific World Journal
                TheScientificWorldJOURNAL
                2356-6140
                1537-744X
                2004
                26 August 2004
                : 4
                : 736-745
                Affiliations
                1 Neurosciences Research, Cahers Inc., 8787 Shenandoah Park Drive, Suite 122, Conroe, Houston, 77385 TX, USA
                2 Clalit Health Services and Division of Community Health, Department of Family Medicine, Ben Gurion University, Beer-Sheva, Israel
                3 Medical Center for Immune and Toxic Disorders, 20510 Oakhurst Drive, Suite 200, Spring TX, USA
                Author notes
                *Ebere C. Anyanwu: ebereanyanwu@ 123456msn.com

                Academic Editor: Joav Merrick

                Article
                957412
                10.1100/tsw.2004.133
                5956359
                15349513
                350ae52a-2c95-41e9-b3f5-368891a0970e
                Copyright © 2004 Ebere C. Anyanwu et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 1 August 2004
                : 18 August 2004
                : 19 August 2004
                Categories
                Review Article

                Uncategorized
                vitamin b12,toxigenic molds,mycotoxins,one-carbon metabolism
                Uncategorized
                vitamin b12, toxigenic molds, mycotoxins, one-carbon metabolism

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