MECHANISTIC ANALYSIS OF VITAMIN B6 DEFICIENCY FOLLOWING SMALL BOWEL TRANSPLANTATION

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Objective. This study was conducted to determine the cause of vitamin B6 deficiency reported following small bowel transplantation. Background. Earlier research has shown that patients following small bowel transplantation developed a vitamin B6 deficiency regardless of vitamin intake or supplementation. Methods. . For this study the urinary metabolite of vitamin B6 4-pyridoxic acid was measured in urine and compared to a matched healthy control subjects. Plasma Alkaline phosphatase, serum albumin and selected cytokines (IL-1², IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, TNF-±, IFN-³) were measured. Results. Twelve hour urinary 4-PA amounts were significantly higher in transplant group (16.92 μmol±3.58). Compared to the control group (1.11 μmol± 0.13) (p-value < 0.05). 4-PA amounts were (1.11 μmol ±0.13), (23.78 μmol ±5.96), and 10.1 μmol ±1.4) in control, transplant session 1 and transplant session 2, respectively. (pvalue < .05). Average alkaline phosphatase (ALKP) was (56.8 IU/L ±3.7) for control group and (112.5 IU/L ±18.4) for transplant group (p-value = 0.007). Average serum Albumin was (4.0 g/dl ±0.14) in the control group and (3.4 g/dl ±0.08) in the transplant group (p-value =0.001). Only IL-6 and TNF-± were significantly higher in transplant patients in both session 1 and 2 than in control group. Both IL-8 and IL-10 were significantly higher than in control during transplant session 1 only. The rest of the cytokines were not significantly different from control group. ANOVA was used for analysis Conclusion. The higher urinary 4-PA amounts seen in the transplant groups may indicate increased degradation. Elevated alkaline phosphatase plasma and decreased serum albumin in transplant patients may lead to increased P5P degradation. Grants. None