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MULTIPLE DISCIPLINE RESEARCH FORUM |

Mechanisms of Folic Acid Deficiency in Nontropical Sprue

Herman Baker, PhD; Oscar Frank, PhD; Harry Sobotka, PhD
[+] Author Affiliations

Peh-Ping Ho, MD, Nathaniel Cohen, MD, Henry Janowitz, MD, and Herman Ziffer, MD, New York, and Carroll M. Leevy, MD, Jersey City, NJ, are co-authors of this study.

Read before the session on nutrition and metabolism at the Third Multiple Discipline Research Forum during the 112th Annual Meeting of the American Medical Association, Atlantic City, NJ, June 18, 1963.


JAMA. 1964;187(2):119-121. doi:10.1001/jama.1964.03060150043010
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THE ANEMIA seen in nontropical sprue is commonly associated with folic (pteroylglutamic) acid deficiency which seems to be due to unknown interferences with absorption of this vitamin. In nontropical sprue there is impaired absorption of orally-administered folic acid as measured by urinary excretion or circulating levels after saturating the tissues with folic acid.1,2 This malabsorption may be related to an enzyme defect in the intestinal mucosal cells.3 The latter supposition initiated the studies reported here.

We have developed an oral folic acid tolerance test using a microbial method which directly correlates serum folate activity with folate absorption and hemopoietic activity. This enabled us to study the absorption of folic acid and two folylglutamate conjugates, pteroyldiglutamic acid (pteroylglutamyl-α-glutamic acid) (Diopterin) and sodium pteroyl triglutamate (pteroylglutamyl-γ-glutamyl-γ-glutamic acid) (Teropterin), in normal subjects, patients with nontropical sprue, and patients with nutritional folate-deficiency anemia.

Materials and Methods  Absorption of a synthetic glutamyl conjugate,

REFERENCES

Girdwood, R.H.:  Folic Acid Excretion Test in Investigation of Intestinal Malabsorption , Lancet 2:53-60, 1953;.
CrossRef
Chanarin, I.; Anderson, B.B.; and Mollin, D.L.:  Absorption of Folic Acid , Brit J Haemat 4:156-166, 1958;.
CrossRef
Gardner, F.H.:  Hematologic Aspects of Sprue , Amer J Clin Nutr 8:179-186, 1960;.
Baker, H., et al:  Microbiologic Method for Detecting Folic Acid Deficiency in Man , Clin Chem 5:275-280, 1959;.
Baker, H., and Sobotka, H.: Microbiologic Assay of Vitamins in Advances in Clinical Chemistry , H. Sobotka and C.P. Stewart, ed., vol 5, New York: Academic Press, 1962;, pp 173-235.
Cherrick, G.R., et al:  Conversion of Diopterin and Teropterin into Folic and Folinic Acid Activity by Rat Liver , Proc Soc Exp Biol Med , to be published.
Padykula, H.A., et al:  Morphological and Histochemical Analysis of Human Jejunal Epithelium in Non-Tropical Sprue , in First International Congress on Histochemistry and Cytochemistry , G. Wegmann, ed., vol 2, New York: Pergamon Press, 1961;, p 187.
Hutner, S.H.; Nathan, H.A.; and Baker, H.:  Metabolism of Folic Acid and Other Pterin-Pteridine Vitamins , Vitamins Hormones (NY) 17:1-52, 1959;.
Girdwood, R.H.:  "Folic Acid, Its Analogs and Antagonists ," in Advances in Clinical Chemistry , H. Sobotka and C.P. Stewart, ed., vol 3, New York: Academic Press, 1960;, pp 235-297.

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Girdwood, R.H.:  Folic Acid Excretion Test in Investigation of Intestinal Malabsorption , Lancet 2:53-60, 1953;.
CrossRef
Chanarin, I.; Anderson, B.B.; and Mollin, D.L.:  Absorption of Folic Acid , Brit J Haemat 4:156-166, 1958;.
CrossRef
Gardner, F.H.:  Hematologic Aspects of Sprue , Amer J Clin Nutr 8:179-186, 1960;.
Baker, H., et al:  Microbiologic Method for Detecting Folic Acid Deficiency in Man , Clin Chem 5:275-280, 1959;.
Baker, H., and Sobotka, H.: Microbiologic Assay of Vitamins in Advances in Clinical Chemistry , H. Sobotka and C.P. Stewart, ed., vol 5, New York: Academic Press, 1962;, pp 173-235.
Cherrick, G.R., et al:  Conversion of Diopterin and Teropterin into Folic and Folinic Acid Activity by Rat Liver , Proc Soc Exp Biol Med , to be published.
Padykula, H.A., et al:  Morphological and Histochemical Analysis of Human Jejunal Epithelium in Non-Tropical Sprue , in First International Congress on Histochemistry and Cytochemistry , G. Wegmann, ed., vol 2, New York: Pergamon Press, 1961;, p 187.
Hutner, S.H.; Nathan, H.A.; and Baker, H.:  Metabolism of Folic Acid and Other Pterin-Pteridine Vitamins , Vitamins Hormones (NY) 17:1-52, 1959;.
Girdwood, R.H.:  "Folic Acid, Its Analogs and Antagonists ," in Advances in Clinical Chemistry , H. Sobotka and C.P. Stewart, ed., vol 3, New York: Academic Press, 1960;, pp 235-297.
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