STUDIES ON THE RELATIONSHIPS OF VITAMIN B12, FOLIC ACID, THYMINE, URACIL, AND METHYL GROUP DONORS IN PERSONS WITH PERNICIOUS ANEMIA AND RELATED MEGALOBLASTIC ANEMIAS

作者：Richard W. Vilter, Daniel L. Horrigan, John F. Mueller, Thomas Jarrold, CARL F. VILTER, V. Hawkins, Arthur J. Seaman · 发表于：Blood · 年份：1950 · DOI：10.1182/blood.v5.8.695.695 · 被引用次数：107 · 研究领域：Folate and B Vitamins Research、Porphyrin Metabolism and Disorders

Abstract 1. Patients with pernicious anemia who are maintained on folic acid, 30 mg. three times a week, for two to three years may have a hematologic relapse which will remit satisfactorily if refined liver extract is given, or partially if the dose of folic acid is increased to 50 mg. daily, or if thymine is given. 2. The hematologic remission succeeding the increased dosage of folic acid is followed within several months by a second relapse. At this time the response of these patients to liver extract or vitamin B12 is retarded. Recovery occurs after two to four months. 3. These experiments suggest that folic acid exerts its effect by "mass action" in pernicious anemia and that it is essential to the formation of thymine and other pyrimidines and purines or facilitates the utilization of these substances. 4. Posterolateral column disease or peripheral neuritis occurred in every person with pernicious anemia who received increasing doses of folic acid to maintain an hematologic remission. This observation suggests that folic acid, by pushing a chemical reaction through to completion in the face of a serious deficiency of vitamin B12, depleted the supply of this factor even more and led to the development of combined system disease. 5. Uracil produced a hematologic response in 2 of 3 persons with pernicious anemia in relapse when given in doses of 15-30 grams daily. The data suggest that uracil may be a precursor of thymine. 6. A patient with pernicious anemia of pregnancy f...