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thiamine

 
Dictionary: thi·a·mine   (thī'ə-mĭn, -mēn') pronunciation also thi·a·min
(-mĭn)
n.

A vitamin, C12H17ClN4OS, of the vitamin B complex, found in meat, yeast, and the bran coat of grains, and necessary for carbohydrate metabolism and normal neural activity. Also called vitamin B1.

[Alteration of thiamin : THI(O)- + (VIT)AMIN.]


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Sci-Tech Encyclopedia: Thiamine
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A water-soluble vitamin found in many foods; pork, liver, and whole grains are particularly rich sources. It is also known as vitamin B1 or aneurin.

Thiamine deficiency is known as beriberi in humans and polyneuritis in birds. Muscle and nerve tissues are affected by the deficiency, and poor growth is observed. People with beriberi are irritable, depressed, and weak. They often die of cardiac failure. Wernicke's disease observed in alcoholics is associated with a thiamine deficiency. This disease is characterized by brain lesions, liver disease, and partial paralysis, particularly of the motor nerves of the eye. As is the case in all B vitamin diseases, thiamine deficiency is usually accompanied by deficiencies of other vitamins.


Food and Nutrition: vitamin B1
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Thiamin; essential in energy-yielding metabolism, especially carbohydrates, and for nerve conduction. Deficiency results in the disease beriberi—degeneration of the sensory nerves in the hands and feet, spreading through the limbs, with fluid retention and heart failure. Relatively acute deficiency, associated with alcohol abuse, results in central nervous system damage, the Wernicke-Korsakoff syndrome.

Good sources are whole grain and enriched bread and cereals, meat (especially liver, kidney, and heart, and pork), yeast, potatoes, and peas; cooking losses can be as much as 50%.

Food and Fitness: vitamin B1
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aneurine, thiamin

A water-soluble vitamin first extracted and isolated from rice polishings. It is also found in lean meat, liver, eggs, wholegrains, and milk. It plays a very important role in releasing energy from foods rich in carbohydrates. Gross deficiency causes the potentially fatal disease known as beriberi. Mild deficiencies cause fatigue, loss of appetite, muscle weakness, and digestive disturbances. Deficiency is also associated with chronic alcohol abuse which may lead to derangement of the central nervous system, enlargement of the heart, and death by heart failure. Vitamin B1 is rapidly destroyed by heat and is stored in the body in very small amounts. In the UK, the Reference Nutrient Intake for adults is 1.0 mg each day for males and 0.8 mg for females. Physically active people may need more thiamin than inactive people. Increased intakes may also be required by those on high carbohydrate diets, during pregnancy, and in other stressful situations.

Drug Info: Thiamine, Vitamin B1
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Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

Description

Thiamine, also known as vitamin B1, was the first of the water-soluble B-vitamin family to be discovered. It is an essential component of an enzyme, thiamine pyrophosphate, that is involved in metabolizing carbohydrates. Thiamine works closely with other B vitamins to assist in the utilization of proteins and fats as well, and helps mucous membranes and the heart to stay healthy. The brain relies on thiamine's role in the conversion of blood sugar (glucose) into biological energy to function properly. Thiamine is also involved in certain key metabolic reactions occurring in nervous tissue, the heart, in the formation of red blood cells, and in the maintenance of smooth and skeletal muscle.

General Use

The recommended daily allowance (RDA) of thiamine is 0.3 mg for infants less than six months old, 0.4 mg for those from six months to one year old, 0.7 mg for children ages one to three years, 0.9 mg for those four to six years, and 1.0 mg for those seven to 10 years. Requirements vary slightly by gender after age 10. Males need 1.3 mg from 11 to 14 years, 1.5 mg from 15 to 50 years, and 1.2 mg when over age 50 years. Females require 1.1 mg from 11 to 50 years of age, and 1.0 mg if older than 50 years. The RDA is slightly higher for women who are pregnant (1.5 mg) or lactating (1.6 mg). Adults need a minimum of 1.0 mg of thiamine a day, but the requirement is increased by approximately 0.5 mg for each 1,000 calories of daily dietary intake over a 2,000-calorie base.

Thiamine has limited therapeutic use apart from supplements for people who are deficient or have significant risk factors for deficiency, such as alcoholism. High doses are used to treat some metabolic disorders, including certain enzyme deficiencies, Leigh's disease, and maple syrup urine disease. People suffering from diabetic neuropathy may sometimes benefit from additional thiamine. This supplementation should be taken only on the advice of a healthcare provider. Claims have been made that it can also help people with Alzheimer's disease, epilepsy, canker sores, depression, fatigue, fibromyalgia, and motion sickness. Improvement of these conditions based on supplementation with thiamine is unsubstantiated. Although a deficiency of thiamine may cause canker sores, taking extra amounts of the vitamin after they appear does not seem to help them heal.

Preparations

Natural Sources

While all plant and animal foods have thiamine, higher levels of thiamine are found in many nuts, seeds, brown rice, seafood, and whole-grain products. Sunflower seeds are a particularly good source. Grains are stripped of the B vitamin content during processing, but it is often added back to breads, cereals, and baked goods. Legumes, milk, beef liver, and pork are other foods with high vitamin B1 content. Thiamine is destroyed by prolonged high temperatures, but not by freezing. Food should be cooked in small amounts of water so that thiamine and other water-soluble vitamins don't leach out. Baking soda should not be added to vegetables, and fresh foods should be eaten to avoid sulfite preservatives. Both of these chemicals will break down the thiamine content found in foods. Drinking tea or alcohol with a meal will also drastically decrease the amount of thiamine that is absorbed by the body.

Supplemental Sources

Thiamine is available in oral, intramuscular injectable, and intravenous formulations. Injectable formulas are usually preserved for persons who are severely thiamine deficient. Supplements should always be stored in a cool dry place, away from direct light, and out of the reach of children.

Deficiency

A deficiency of thiamine leads to a condition known as beriberi. Once common in sailors, it has become rare in the industrialized parts of the world except in cases of alcoholism and certain disease conditions. Beriberi is, however, frequently found in refugee camps and similar shelters for displaced persons. Infantile beriberi is presently the leading cause of death among the children of ethnic minority groups in southeast Asia. The syndrome typically causes poor appetite, abdominal pain, heart enlargement, constipation, weakness, swelling of limbs, muscle spasms, insomnia, and memory loss. Under treatment, the condition can resolve very quickly. Untreated beriberi will lead eventually to Wernicke-Korsakoff syndrome. These patients experience confusion, disorientation, inability to speak, gait difficulties, numbness or tingling of extremities, edema, nausea, vomiting, visual difficulties, and may progress to psychosis, coma, and death. Even in advanced states, this condition can be reversible if thiamine is given, nutritional status is improved, and use of alcohol is stopped.

Risk Factors for Deficiency

The leading risk factor for developing a deficiency of thiamine is alcoholism. Generally, alcoholics eat poorly, and therefore have a low dietary intake of thiamine and other vitamins to begin with. Alcohol also acts directly to destroy thiamine and increases the excretion of it. People with cirrhosis of the liver, malabsorption syndromes, diabetes, kidney disease, chronic infections, or hypermetabolic conditions also have increased susceptibility to thiamine deficiency. The elderly are more prone to poor nutritional status as well as difficulties with absorption, and may need a supplement. Others with nutritionally inadequate diets, or an increased need as a result of stress, illness, or surgery may benefit from additional vitamin B1 intake since utilization is higher under these conditions. Those who diet or fast frequently may also be at risk for low levels of thiamine. Use of tobacco products, or carbonate and citrate food additives can impair thiamine absorption. A shortage of vitamin B1 is likely to be accompanied by a shortage of other B vitamins, and possibly other nutrients as well. A supplement containing a balance of B complex and other vitamins is usually the best approach unless there is a specific indication for a higher dose of thiamine, or other individual vitamins.

Precautions

Thiamine should not be taken by anyone with a known allergy to B vitamins, which occurs rarely.

Side Effects

In very unusual circumstances, large doses of thiamine may cause rashes, itching, or swelling. These reactions are more common with intravenous injections than oral supplements. Most people do not experience any side effects from oral thiamine.

Interactions

Oral contraceptives, antibiotics, sulfa drugs, and certain types of diuretics may lower thiamine levels in the body. Consult a health care professional about the advisability of supplementation. Taking this vitamin may also intensify the effects of neuromuscular blocking agents that are used during some surgical procedures. B vitamins are best absorbed as a complex, and magnesium also promotes the absorption of thiamine.

Resources

Books

Bratman, Steven, and David Kroll. Natural Health Bible. Rocklin, CA: Prima Publishing, 1999.

Griffith, H. Winter. Vitamins, Herbs, Minerals & Supplements: The Complete Guide. Arizona: Fisher Books, 1998.

Jellin, Jeff, Forrest Batz, and Kathy Hitchens. Pharmacist's Letter/Prescriber's Letter Natural Medicines Comprehensive Database. California: Therapeutic Research Faculty, 1999.

Pressman, Alan H., and Sheila Buff. The Complete Idiot's Guide to Vitamins and Minerals. New York: Alpha Books, 1997.

Periodicals

McGready, Rose, Julie A. Simpson, Thein Cho, et al. "Postpartum Thiamine Deficiency in a Karen Displaced Population." American Journal of Clinical Nutrition 74 (December 2001): 808–813.

Other

American Society for Nutritional Sciences. .

[Article by: Judith Turner; Rebecca J. Frey, PhD]


Organic compound, part of the vitamin B complex, necessary in carbohydrate metabolism. It carries out these functions in its active form, as a component of the coenzyme thiamin pyrophosphate. Its molecular structure includes a substituted pyridine ring and a thiazole ring. Thiamin is found most abundantly in whole cereal grains and certain other seeds. Deficiency leads to beriberi.

For more information on thiamin, visit Britannica.com.


thiamine

A water-soluble vitamin first extracted and isolated from rice polishings. It is also found in lean meat, liver, eggs, wholegrains, and milk. It plays a very important role in releasing energy from foods rich in carbohydrates. Gross deficiency causes the potentially fatal disease known as ben-ben. Mild deficiencies cause fatigue, loss of appetite, muscle weakness, and digestive disturbances. Vitamin B1 is rapidly destroyed by heat and is stored in the body in very small amounts.

Wikipedia: Thiamine
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Thiamine
Thiamin.svg
Thiamine-3D-vdW.png
IUPAC name
Other names Aneurine hydrochloride, thiamin
Identifiers
CAS number 59-43-8 (Cl-Yes check.svgY,67-03-8 (Cl-.HCl hydrochloride)
PubChem 1130
MeSH Thiamine
SMILES
ChemSpider ID 5819
Properties
Molecular formula C12H17N4OS+Cl-.HCl
Molar mass 337.27
Melting point

248-260 °C (hydrochloride salt)

Hazards
Main hazards Allergies
 Yes check.svgY (what is this?)  (verify)
Except where noted otherwise, data are given for materials in their standard state (at 25 °C, 100 kPa)
Infobox references

Thiamine or thiamin,[1] sometimes called aneurin, is a water-soluble vitamin of the B complex (vitamin B1), whose phosphate derivatives are involved in many cellular processes. The best characterized form is thiamine diphosphate (ThDP), a coenzyme in the catabolism of sugars and amino acids. In yeast, ThDP is also required in the first step of alcoholic fermentation.

Thiamine is synthesized in bacteria, fungi and plants. Animals must cover all their needs from their food and insufficient intake results in a disease called beriberi affecting the peripheral nervous system (polyneuritis) and/or the cardiovascular system, with fatal outcome if not cured by thiamine administration.[2] In less severe deficiency, nonspecific signs include malaise, weight loss, irritability and confusion.[3] Today, there is still a lot of work devoted to elucidating the exact mechanisms by which thiamine deficiency leads to the specific symptoms observed (see below). Finally, new thiamine phosphate derivatives have recently been discovered,[4] emphasizing the complexity of thiamine metabolism and the need for more research in the field.

Contents

History: The discovery of vitamins and the biochemical lesion

Thiamine was the first of the water-soluble vitamins to be described,[2] leading to the discovery of more such trace compounds essential for survival and to the notion of vitamin. Chinese medical texts referred to beriberi (a thiamine deficiency disease) as early as 2700 BC.[5] It was not until AD 1884 that Kanehiro Takaki (1849-1920), a surgeon general in the Japanese navy, rejected the previous germ theory and attributed the disease to insufficient nitrogen intake (protein deficiency).

In 1897 Christiaan Eijkman (1858-1930), a military doctor in the Dutch Indies, discovered that fowl fed on a diet of cooked, polished rice developed paralysis, which could be reversed by discontinuing rice polishing.[6] He attributed that to a nerve poison in the endosperm of rice, from which the outer layers of the grain gave protection to the body. Eijkman was awarded the Nobel Prize in Physiology and Medicine in 1929, because his observations led to the discovery of vitamins. An associate, Gerrit Grijns (1865-1944), correctly interpreted the connection between excessive consumption of polished rice and beriberi in 1901: he concluded that rice contained an essential nutrient in the outer layers of the grain that was removed by polishing.[7]

In 1911 Casimir Funk isolated an antineuritic substance from rice bran that he called a “vitamine” (on account of its containing an amino group). Dutch chemists, Barend Coenraad Petrus Jansen (1884-1962) and his closest collaborator Willem Frederik Donath (1889-1957), went on to isolate and crystallize the active agent in 1926,[8] whose structure was determined by Robert Runnels Williams (1886-1965), a US chemist, in 1934. Thiamine (“sulfur-containing vitamin”) was synthesized in 1936 by the same group[9].

It was first named “aneurin” (for anti-neuritic vitamin).[10] Sir Rudolph Peters, in Oxford, introduced thiamine-deprived pigeons as a model for understanding how thiamine deficiency can lead to the pathological-physiological symptoms of beriberi. Indeed, feeding the pigeons upon polished rice leads to an easily recognizable behavior of head retraction, a condition called opisthotonos. If not treated, the animal will die after a few days. Administration of thiamine at the stage of opithotonos will lead to a complete cure of the animal within 30 min. As no morphological modifications were observed in the brain of the pigeons before and after treatment with thiamine, Peeters introduced the concept of biochemical lesion[11]

When Lohman and Schuster (1937) showed that the diphosphorylated thiamine derivative (thiamine diphosphate, ThDP) was a cofactor required for the oxydative decarboxylation of pyruvate,[12] (a reaction now known to be catalyzed by pyruvate dehydrogenase), the mechanism of action of thiamine in the cellular metabolism seemed to be elucidated. Presently, this view seems to be oversimplified: pyruvate dehydrogenase is only one of several enzymes requiring thiamine diphosphate as a cofactor, moreover other thiamine phosphate derivatives have been discovered since then, and they may also contribute to the symptoms observed during thiamine deficiency.

Finally, the mechanism by which the thiamine moiety of ThDP exerts its coenzyme function by proton substitution on position 2 of the thiazolium ring was elucidated by Ronald Breslow in 1958.[13]

Chemical properties

Thiamine is a colorless compound with a chemical formula C12H17N4OS. Its structure contains a pyrimidine ring and a thiazole ring linked by a methylene bridge. Thiamine is soluble in water, methanol, and glycerol and practically insoluble in acetone, ether, chloroform, and benzene. It is stable at acidic pH, but is unstable in alkaline solutions.[2][14] Thiamine is unstable to heat, but stable during frozen storage. It is unstable when exposed to ultraviolet light[14] and gamma irradiation.[15][16] Thiamine reacts strongly in Maillard-type reactions.[2]

Biosynthesis

Complex thiamine biosynthetic pathways occur in bacteria, some protozoans, plants and fungi.[17][18] The thiazole and pyrimidine moieties are synthesized separately and then assembled to form ThMP by thiamine-phosphate synthase (EC 2.5.1.3). The exact biosynthetic pathways may differ among organisms. In E. coli and other enterobacteriaceae ThMP may be phosphorylated to the cofactor ThDP by a thiamine-phosphate kinase (ThMP + ATP → ThDP + ADP, EC 2.7.4.16). In most bacteria and in eukaryotes, ThMP is hydrolyzed to thiamine, that may then be pyrophosphorylated to ThDP by thiamine diphosphokinase (thiamine + ATP → ThDP + AMP, EC 2.7.6.2).

Nutrition

References

Thiamine is found in a wide variety of foods at low concentrations. Yeast and pork are the most highly concentrated sources of thiamine. Cereal grains, however, are generally the most important dietary sources of thiamine, by virtue of their ubiquity. Of these, whole grains contain more thiamine than refined grains, as thiamine is found mostly in the outer layers of the grain and in the germ (which are removed during the refining process). For example, 100 g of whole wheat flour contains 0.55 mg of thiamine, while 100 g of white flour only contains 0.06 mg of thiamine. In the US, processed flour must be enriched with thiamine mononitrate (along with niacin, ferrous iron, riboflavin and folic acid) to replace that lost in processing.

Some other foods rich in thiamine are oatmeal, flax and Sunflower seeds, brown rice, whole grain rye, asparagus, kale, cauliflower, potatoes, oranges, liver (beef, pork and chicken) and eggs.[3]

Thiamine hydrochloride is a food additive used to add a brothy/meaty flavor to gravies or soups.

Reference Daily Intake and high doses

The RDA in most countries is set at about 1.4 mg. However, tests on volunteers at daily doses of about 50 mg have claimed an increase in mental acuity.[19] There are no reports available of adverse effects from consumption of excess thiamine by ingestion of food and supplements. Because the data are inadequate for a quantitative risk assessment, no Tolerable Upper Intake Level (UL) can be derived for thiamine.

Antagonists

Thiamine in foods can be degraded in a variety of ways. Sulfites, which are added to foods usually as a preservative,[20] will attack thiamine at the methylene bridge in the structure, cleaving the pyrimidine ring from the thiazole ring.[3] The rate of this reaction is increased under acidic conditions. Thiamine is degraded by thermolabile thiaminases (present in raw fish and shellfish[2]). Some thiaminases are produced by bacteria. Bacterial thiaminases are cell surface enzymes that must dissociate from the membrane before being activated; the dissociation can occur in ruminants under acidotic conditions. Rumen bacteria also reduce sulfate to sulfite, therefore high dietary intakes of sulfate can have thiamine-antagonistic activities.

Plant thiamine antagonists are heat stable and occur as both the ortho and para hydroxyphenols. Some examples of these antagonists are caffeic acid, chlorogenic acid and tannic acid. These compounds interact with the thiamine to oxidize the thiazole ring, thus rendering it unable to be absorbed. Two flavonoids, quercetin and rutin, have also been implicated as thiamine antagonists.[3]

Absorption and transport

Absorption

Thiamine is released by the action of phosphatase and pyrophosphatase in the upper small intestine. At low concentrations the process is carrier mediated and at higher concentrations, absorption occurs via passive diffusion. Active transport is greatest in the jejunum and ileum (it is inhibited by alcohol consumption and by folic deficiency.[2] Decline in thiamine absorption occurs at intakes above 5 mg.[21] The cells of the intestinal mucosa have thiamine pyrophosphokinase activity, but it is unclear whether the enzyme is linked to active absorption. The majority of thiamine present in the intestine is in the pyrophosphorylated form ThDP, but when thiamine arrives on the serosal side of the intestine it is often in the free form. The uptake of thiamine by the mucosal cell is likely coupled in some way to its phosphorylation/dephosphorylation. On the serosal side of the intestine, evidence has shown that discharge of the vitamin by those cells is dependent on Na+-dependent ATPase.[3]

Bound to serum proteins

The majority of thiamine in serum is bound to proteins, mainly albumin. Approximately 90% of total thiamine in blood is in erythrocytes. A specific binding protein called thiamine-binding protein (TBP) has been identified in rat serum and is believed to be a hormonally regulated carrier protein that is important for tissue distribution of thiamine.[3]

Cellular uptake

Uptake of thiamine by cells of the blood and other tissues occurs via active transport and passive diffusion.[2] About 80% of intracellular thiamine is phosphorylated and most is bound to proteins. In some tissues, thiamine uptake and secretion appears to be mediated by a soluble thiamine transporter that is dependent on Na+ and a transcellular proton gradient.[3]

Tissue distribution

Human storage of thiamine is about 25 to 30 mg with the greatest concentrations in skeletal muscle, heart, brain, liver, and kidneys. ThMP and free (unphosphorylated) thiamine is present in plasma, milk, cerebrospinal fluid, and likely all extracellular fluids. Unlike the highly phosphorylated forms of thiamine, ThMP and free thiamine are capable of crossing cell membranes. Thiamine contents in human tissues are less than those of other species.[3][22]

Excretion

Thiamine and its acid metabolites (2-methyl-4-amino-5-pyrimidine carboxylic acid, 4-methyl-thiazole-5-acetic acid and thiamine acetic acid) are excreted principally in the urine.[14]

Thiamine phosphate derivatives and function

Thiamine is mainly the transport form of the vitamin, while the active forms are phosphorylated thiamine derivatives. There are four known natural thiamine phosphate derivatives: thiamine monophosphate (ThMP), thiamine diphosphate (ThDP), also sometimes called thiamine pyrophosphate (TPP), thiamine triphosphate (ThTP), and the recently discovered adenosine thiamine triphosphate (AThTP) and adenosine thiamine diphosphate (AThDP).

Thiamine monophosphate

There is no known physiological role of ThMP.

Thiamine diphosphate

The synthesis of thiamine diphosphate (ThDP), also known as thiamine pyrophosphate (TPP) or cocarboxylase, is catalyzed by an enzyme called thiamine diphosphokinase according to the reaction thiamine + ATP → ThDP + AMP (EC 2.7.6.2). ThDP is a coenzyme for several enzymes that catalyze the transfer of two-carbon units and in particular the dehydrogenation (decarboxylation and subsequent conjugation with coenzyme A) of 2-oxoacids (alpha-keto acids). Examples include:

The enzymes transketolase, pyruvate dehydrogenase (PDH) and 2-oxoglutarate dehydrogenase (OGDH) are all important in carbohydrate metabolism. The cytosolic enzyme transketolase is a key player in the pentose phosphate pathway required for the biosynthesis of NADPH and the pentose sugars deoxyribose and ribose. The mitochondrial PDH and OGDH are part of biochemical pathways that result in the generation of adenosine triphosphate (ATP), which is a major form of energy for the cell. PDH links glycolysis to the citric acid cycle, while the reaction catalyzed by OGDH is a rate-limting step in the citric acid cycle. In the nervous system, PDH is also involved in the production of acetylcholine, a neurotransmitter, and for myelin synthesis.[23]

Thiamine triphosphate

Thiamine triphosphate (ThTP) was long considered a specific neuroactive form of thiamine. However, recently it was shown that ThTP exists in bacteria, fungi, plants and animals suggesting a much more general cellular role.[24] In particular in E. coli, it seems to play a role in response to amino acid starvation.[25]

Adenosine thiamine triphosphate

Adenosine thiamine triphosphate (AThTP) or thiaminylated adenosine triphosphate has recently been discovered in Escherichia coli where it accumulates as a result of carbon starvation.[4] In E. coli, AThTP may account for up to 20 % of total thiamine. It also exists in lesser amounts in yeast, roots of higher plants and animal tissue.[26]

Adenosine thiamine diphosphate

Adenosine thiamine diphosphate (AThDP) or thiaminylated adenosine diphosphate exists in small amounts in vertebrate liver, but its role remains unknown.[26]

Deficiency

Thiamine derivatives and thiamine-dependent enzymes are present in all cells of the body, thus, a thiamine deficiency would seem to adversely affect all of the organ systems. However, the nervous system and the heart are particularly sensitive to thiamine deficiency, because of their high oxidative metabolism.

Thiamine deficiency can lead to severe fatigue of eyes and myriad problems including neurodegeneration, wasting and death. A lack of thiamine can be caused by malnutrition, a diet high in thiaminase-rich foods (raw freshwater fish, raw shellfish, ferns) and/or foods high in anti-thiamine factors (tea, coffee, betel nuts)[27] and by grossly impaired nutritional status associated with chronic diseases, such as alcoholism, gastrointestinal diseases, HIV-AIDS, and persistent vomiting.[28] It is thought that many people with diabetes have a deficiency of thiamine and that this may be linked to some of the complications that can occur.[29][30]

Well-known syndromes caused by thiamine deficiency include beriberi and Wernicke-Korsakoff syndrome, diseases also common with chronic alcoholism.

Beriberi

Beriberi is a neurological and cardiovascular disease. The three major forms of the disorder are dry beriberi, wet beriberi, and infantile beriberi.[14]

  • Dry beriberi is characterized principally by peripheral neuropathy consisting of symmetric impairment of sensory, motor, and reflex functions affecting distal more than proximal limb segments and causing calf muscle tenderness.[28]
  • Wet beriberi is associated with mental confusion, muscular wasting, edema, tachycardia, cardiomegaly, and congestive heart failure in addition to peripheral neuropathy.[2]
  • Infantile beriberi occurs in infants breast-fed by thiamin-deficient mothers (who may show no sign of thiamine deficiency). Infants may manifest cardiac, aphonic, or pseudomeningitic forms of the disorder. Infants with cardiac beriberi frequently exhibit a loud piercing cry, vomiting, and tachycardia.[14] Convulsions are not uncommon, and death may ensue if thiamine is not administered promptly.[28]

Following thiamine treatment, rapid improvement occurs generally within 24 hours.[14] Improvements of peripheral neuropathy may require several months of thiamine treatment.[31]

Alcoholic brain disease

Nerve cells and other supporting cells (such as glial cells) of the nervous system require thiamine. Examples of neurologic disorders that are linked to alcohol abuse include Wernicke’s encephalopathy (WE, Wernicke-Korsakoff syndrome) and Korsakoff’s psychosis (alcohol amnestic disorder) as well as varying degrees of cognitive impairment.[32]

Wernicke’s encephalopathy is the most frequently encountered manifestation of thiamine deficiency in Western society,[33] though it may also occur in patients with impaired nutrition from other causes, such as gastrointestinal disease,[33] those with HIV-AIDS, and with the injudicious administration of parenteral glucose or hyperalimentation without adequate B-vitamin supplementation.[34] This is a striking neuro-psychiatric disorder characterized by paralysis of eye movements, abnormal stance and gait, and markedly deranged mental function.[35]

Alcoholics may have thiamine deficiency because of the following:

  • inadequate nutritional intake: alcoholics tend to intake less than the recommended amount of thiamine.
  • decreased uptake of thiamine from the GI tract: active transport of thiamine into enterocytes is disturbed during acute alcohol exposure.
  • liver thiamine stores are reduced due to hepatic steatosis or fibrosis.[36]
  • impaired thiamine utilization: magnesium, which is required for the binding of thiamine to thiamine-using enzymes within the cell, is also deficient due to chronic alcohol consumption. The inefficient utilization of any thiamine that does reach the cells will further exacerbate the thiamine deficiency.
  • Ethanol per se inhibits thiamine transport in the gastrointestinal system and blocks phosphorylation of thiamine to its cofactor form (ThDP).[37]

Korsakoff Psychosis is generally considered to occur with deterioration of brain function in patients initially diagnosed with WE.[38]. This is an amnestic-confabulatory syndrome characterized by retrograde and anterograde amnesia, impairment of conceptual functions, and decreased spontaneity and initiative.<[28]

Following improved nutrition and the removal of alcohol consumption, some impairments linked with thiamine deficiency are reversed; particularly poor brain functionality, although in more severe cases, Wernicke-Korsakoff syndrome leaves permanent damage. (See delirium tremens.)

Thiamine deficiency in poultry

As most feedstuffs used in poultry diets contain enough quantities of vitamins to meet the requirements in this species, deficiencies in this vitamin does not occur with commercial diets. This was, at least, the opinion in the 1960s.[39]

Mature chickens show signs 3 weeks after being fed a deficient diet. In young chicks, it can appear before 2 weeks of age.

Onset is sudden in young chicks. There is anorexia and an unsteady gait. Later on, there are locomotor signs, beginning with an apparent paralysis of the flexor of the toes. The characteristic position is called "stargazing", meaning a chick "sitting on its hocks and the head in opisthotonos.

Response to administration of the vitamin is rather quick, occurring a few hours later.[40][41]

Differential diagnosis include riboflavin deficiency and avian encephalomyelitis. In riboflavin deficiency, the "curled toes" is a characteristic symptom. Muscle tremor is typical of avian encephalomyelitis. A therapeutic diagnosis can be tried by supplementing Vitamin B1 only in the affected bird. If the animals do not respond in a few hours, Vitamin B1 deficiency can be excluded.

Thiamine deficiency in ruminants

Polioencephalomalacia(PEM), is the most common thiamine deficiency disorder in young ruminant and nonruminant animals. Symptoms of PEM include a profuse, but transient diarrhea, listlessness, circling movements, star gazing or opisthotonus (head drawn back over neck), and muscle tremors.[42] The most common cause is high-carbohydrate feeds, leading to the overgrowth of thiaminase-producing bacteria, but dietary ingestion of thiaminase (e.g. in bracken fern), or inhibition of thiamine absorption by high sulfur intake are also possible.[43]

Idiopathic paralytic disease in wild birds

Recently thiamine deficiency has been identified as the cause of a paralytic disease affecting wild birds in the Baltic Sea area dating back to 1982.[44] In this condition, there is difficulty in keeping the wings folded along the side of the body when resting, loss of the ability to fly and voice with eventual paralysis of the wings and legs and death. It affects primarily 0.5–1 kg sized birds such as the herring gull (Larus argentatus), Common Starling (Sturnus vulgaris) and Common Eider (Somateria mollissima). Researches noted "Because the investigated species occupy a wide range of ecological niches and positions in the food web, we are open to the possibility that other animal classes may suffer from thiamine deficiency as well."[44]p. 12006

Analysis and diagnostic testing

Oxidation of thiamine derivatives to fluorescent thiochromes by potassium ferricyanide under alkaline conditions

A positive diagnosis test for thiamine deficiency can be ascertained by measuring the activity of the enzyme transketolase in erythrocytes (Erythrocyte Transketolase Activation Assay). Thiamine, as well as its phosphate derivatives, can also be detected directly in whole blood, tissues, foods, animal feed and pharmaceutical preparations following the conversion of thiamine to fluorescent thiochrome derivatives (Thiochrome Assay) and separation by high performance liquid chromatography (HPLC).[45][46][47] In recent reports, a number of Capillary Electrophoresis (CE) techniques and in-capillary enzyme reaction methods have emerged as potential alternative techniques for the determination and monitoring of thiamine in samples.[48]

Genetic diseases

Genetic diseases of thiamine transport are rare but serious. Thiamine Responsive Megaloblastic Anemia with diabetes mellitus and sensorineural deafness (TRMA)[49] is an autosomal recessive disorder caused by mutations in the gene SLC19A2,[50] a high affinity thiamine transporter. TRMA patients do not show signs of systemic thiamine deficiency, suggesting redundancy in the thiamine transport system. This has led to the discovery of a second high affinity thiamine transporter, SLC19A3.[51][52] Leigh Disease (Subacute Necrotising Encephalomyelopathy) is an inherited disorder which affects mostly infants in the first years of life and is invariably fatal. Pathological similarities between Leigh disease and WE led to the hypothesis that the cause was a defect in thiamine metabolism. One of the most consistent findings has been an abnormality of the activation of the pyruvate dehydrogenase complex[53]

Other disorders in which a putative role for thiamine has been implicated include Subacute Necrotizing Encephalomyelopathy, Opsoclonic Cerebellopathy (a paraneoplastic syndrome), and Nigerian Seasonal Ataxia. In addition, several inherited disorders of ThDP-dependent enzymes have been reported,[54] which may respond to thiamine treatment.[28]

Research

Research in the field mainly concerns the mechanisms by which thiamine deficiency leads to neuronal death in relation to Wernicke Korsakoff Psychosis. Another important field concerns the understanding of the molecular mechanisms involved in ThDP catalysis. More recently, research has been devoted to the understanding of the possible non-cofactor roles of other derivatives such as ThTP and AThTP.

Understanding the mechanism by which thiamine deficiency leads to selective neuronal death

Experimentally induced beriberi polyneuropathy in chickens may be a good model for studying these forms of neuropathy in view of diagnosis and treatment.[55] From studies using rat models, a link between thiamine deficiency and colon carcinogenesis was suggested.[56] Rat model is used also in research of Wernicke's encephalopathy.[57] Thiamine deprived mice are a classic model of systemic oxidative stress, used in research of Alzheimer’s disease.[58]

Catalytic mechanisms in thiamine diphosphate-dependent enzymes

A lot of work is devoted to the understanding of the interplay between ThDP and ThDP-dependent enzymes in catalysis.[59][60]

Non-cofactor roles of thiamine derivatives

Thiamine compounds other than ThDP exist in most cells from many organisms, including bacteria, fungi, plants and animals. Among those compounds are thiamine triphosphate (ThTP) and adenosine thiamine triphosphate (AThTP) are thought to have non-cofactor roles, though at present it is not known to what extent they participate in the symptoms [4][26][61][62]

See also

References

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