Vitamina B 12, cianocobalamina e derivati Human cobalamin deficiency: alterations in serum tumour necrosis factor-alpha and epidermal growth

factor. Peracchi M, Bamonti Catena F, Pomati M, et al. ur ! Haematol "##$%&':$"(-$"'. Objectives:We have previously demonstrated that vitamin B12 (cobalamin)-de icient central neuropathy in the rat is associated !ith local overe"pression o neuroto"ic tumour necrosis actor (#$%)-alpha combined !ith locally decreased synthesis o neurotrophic epidermal &ro!th actor ('(%)) #he aims o this study !ere to investi&ate !hether a similar imbalance also occurs in the serum o adult patients !ith clinically con irmed cobalamin de iciency and !hether it can be corrected by vitamin B12 replacement therapy) *atients and methods: We studied +, adult patients !ith severe cobalamin de iciency, 12 patients !ith pure iron de iciency anaemia and +, control subjects) -aematolo&ical mar.ers o cobalamin de iciency and serum #$%-alpha and '(% levels !ere measured usin& commercial .its) #hirteen cobalamin-de icient patients !ere re-evaluated a ter + and / months o parenteral vitamin B12 treatment) 0esults: #$%-alpha !as si&ni icantly hi&her (p 1 2)21) and '(% si&ni icantly lo!er (p 1 2)21) in the patients !ith cobalamin de iciency, but both !ere unchan&ed in patients !ith pure iron de iciency anaemia) 3n cobalamin-de icient patients the serum #$%-alpha levels correlated si&ni icantly !ith plasma total homocysteine levels (r 4 2),256 p 1 2)22)) 3n the treated patients #$%-alpha and '(% levels normalised concomitantly !ith clinical and haematolo&ical disease remission) 7onclusions: 3n humans, as in rats, cobalamin concentration appears to be correlated !ith the synthesis and release o #$%-alpha and '(% in a reciprocal manner, because cobalamin de iciency is accompanied by overproduction o #$%-alpha and underproduction o '(%)