| Summary: | 碩士 === 中山醫學大學 === 營養科學研究所 === 92 === Vitamin B6 is involved in the metabolism of amino acid, nucleic acid, glycogen, porphyrin and lipid. Vitamin B6 thus has major effects on immune functions. Vitamin B6 deficiency has been found to significantly impair both humoral- and cell-mediated immunity. In addition, critically ill patients may have marginal vitamin B6 deficiency which may further contribute to a decrease in plasma homocysteine concentrations. The purposes of this study were: (1) to compare vitamin B6 status, immune responses, inflammation and homocysteine concentrations in critically ill patients with that of healthy controls; (2) to investigate the effect of vitamin B6 status on immune responses, inflammation and plasma homocysteine concentrations. Forty patients who stayed over 8 days in the intensive care unit of Taichung Venteran General Hospital and thirty-eight healthy control subjects were recruited. The levels of serum albumin, hemoglobin, hematocrit, high sensitive- C reactive protein (hs-CRP), and immune responses [white blood cell (WBC), neutrophil, total lymphocyte count (TLC), T- (CD3) and B- (CD19) lymphocyte, T-helper (CD4) and T-suppressor (CD8) were determined. Vitamin B6 status was assessed by using plasma pyridoxal 5’-phosphate (PLP) and 4-pyridoxic acid (4-PA), urine 4-PA, erythrocyte aspartate transaminase activity coefficient (EAST -AC) and erythrocyte alanine transaminase activity coefficient (EALT -AC). Plasma homocysteine concentrations, serum folic acid and vitamin B12 were also measured. Results show that control healthy subjects had normal and significantly higher levels of albumin, TLC, CD3, CD19, CD4, CD8 and plasma PLP concentrations and significantly lower levels of WBC, hs-CRP, plasma 4-PA and plasma homocysteine concentrations than these of critically ill patients at baseline. After day 8 critically ill patients had significant increases in plasma 4-PA concentrations, TLC, CD3 and CD4 but significant decreases in hs-CRP, APACHE II score. Plasma PLP concentrations was positively correlated with TLC (r =0.543, p < 0.001), CD3 (r =0.497, p < 0.001), CD19 (r =0.417, p < 0.001), CD4 (r =0.430, p < 0.001) and CD8 (r =0.439, p < 0.001). Plasma PLP concentrations was negatively correlated with WBC (r =-0.418, p < 0.001), neutrophils (r =-0.503, p < 0.001), CRP (r =-0.594, p < 0.001) and plasma homocysteine concentrations ( r =-0.222, p < 0.05). The data suggest that plasma PLP is a strong indicator of immune responses and inflammation in human subjects.
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