Folkers K, Ellis J, Watanabe T, Saji S, Kaji M
Proc Natl Acad Sci U S A. 1978 Jul;75(7):3410-2. doi: 10.1073/pnas.75.7.3410.
In a patient with severe carpal tunnel syndrome and a significant deficiency of vitamin B(6), the evidence for the deficiency was an extraordinarily low basal specific activity of the glutamic-oxaloacetic transminase of the erythrocytes (EGOT). This enzyme was also deficient in pyridoxal phosphate. The patient was treated with the recommended dietary allowance of pyridoxine, 2 mg/day, for 11 weeks, then 100 mg/day for 12 weeks, a placebo for 9 weeks, and again pyridoxine at 100 mg/day for 11 weeks. Sixty-one monitorial assays of EGOT over 48 weeks supported the following interpretations. (i) His diet permitted the development of a debilitating carpal tunnel syndrome. (ii) Treatment with pyridoxine at 2 mg/day reduced the deficiency of EGOT activity from about 70% to 50%, maintained a deficiency of pyridoxal phosphate, and relieved but allowed a marginal syndrome. (iii) Treatment at 100 mg/day for 12 weeks nearly achieved a "ceiling" level of EGOT and eliminated the deficiency of pyridoxal phosphate. (iv) After placebo for 7 weeks, the deficiencies of EGOT activity and pyridoxal phosphate reappeared, and clinical symptoms become worse. (v) Retreatment at 100 mg/day reestablished a "ceiling" EGOT, with no deficiency of pyridoxal phosphate, and the patient was asymptomatic. These data also support the concept that a deficiency of vitamin B(6) is significant in the etiology of the carpal tunnel syndrome. Mechanistically, a state of deficiency of the coenzyme seems to lower the level of the apoenzyme; a state of no deficiency of the coenzyme regulates a ceiling level of the transaminase. The latter state is presumably desired for health.
在一名患有严重腕管综合征且维生素B6严重缺乏的患者中，缺乏维生素B6的证据是红细胞谷草转氨酶（EGOT）的基础比活性极低。这种酶在磷酸吡哆醛中也缺乏。该患者接受了推荐的膳食吡哆醇摄入量，即每天2毫克，持续11周，然后每天100毫克，持续12周，接着服用9周安慰剂，之后再次每天服用100毫克吡哆醇，持续11周。在48周内对EGOT进行的61次监测分析支持了以下解释。（i）他的饮食导致了使人衰弱的腕管综合征的发展。（ii）每天服用2毫克吡哆醇治疗使EGOT活性缺乏从约70%降至50%，维持了磷酸吡哆醛的缺乏，并缓解了症状，但仍有轻微综合征。（iii）每天100毫克治疗12周几乎达到了EGOT的“上限”水平，并消除了磷酸吡哆醛的缺乏。（iv）服用7周安慰剂后，EGOT活性和磷酸吡哆醛的缺乏再次出现，临床症状加重。（v）再次每天100毫克治疗重新建立了“上限”EGOT，且没有磷酸吡哆醛缺乏，患者无症状。这些数据也支持了维生素B6缺乏在腕管综合征病因中具有重要意义的概念。从机制上讲，辅酶缺乏状态似乎会降低脱辅酶水平；辅酶不缺乏状态则调节转氨酶的上限水平。后一种状态大概是健康所需要的。
