Habtie Tesfaye Engdaw, Zemariam Alemu Birara, Dagnaw Betelhem Walelgn, Alamaw Addis Wondmagegn, Feleke Sefineh Fenta, Adisu Molalign Aligaz
Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia.
Department of Pediatrics and Child Health Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia.
Oxid Med Cell Longev. 2025 May 26;2025:8463993. doi: 10.1155/omcl/8463993. eCollection 2025.
The aim of this review is to draw attention to key findings from various published studies concerning the effect of methylcobalamin/cyanocobalamin on the immune response of patients diagnosed with pernicious anemia (PA). This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure the accuracy and reliability of the included randomized controlled trials (RCTs) evaluating the impact of vitamin B12, in either natural or synthetic form, on immune function in patients with PA. The protocol was registered with PROSPERO (CRD42024518621). Methylcobalamin/Cyanocobalamin administration in PA patients significantly increased CD3, CD8+, and CD19 cell levels, restoring them toward normal. Natural Killer (NK) cell activity improved, while the CD4/CD8 ratio decreased. These findings indicate a potential enhancement of immune function in PA patients. Significant restoration of CD3, CD8+, and CD19 cell counts was observed in PA patients after vitamin B12 administration, whether in its natural (methylcobalamin) or synthetic (cyanocobalamin) form. Additionally, NK cell activity was improved, and the CD4/CD8 ratio decreased. These findings suggest that methylcobalamin/cyanocobalamin has the potential to significantly enhance immunity in patients with PA. Therefore, we recommend conducting well-designed, large-scale Phase II and Phase III clinical trials with standardized methodologies to validate these findings and provide more robust evidence on the immunomodulatory effect of vitamin B12 in PA patients.
本综述的目的是提请关注已发表的各项研究的关键发现，这些研究涉及甲钴胺/氰钴胺对被诊断为恶性贫血（PA）患者免疫反应的影响。本系统综述遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南，以确保纳入的随机对照试验（RCT）的准确性和可靠性，这些试验评估了天然或合成形式的维生素B12对PA患者免疫功能的影响。该方案已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42024518621）登记。在PA患者中给予甲钴胺/氰钴胺可显著提高CD3、CD8+和CD19细胞水平，使其恢复正常。自然杀伤（NK）细胞活性改善，而CD4/CD8比值降低。这些发现表明PA患者的免疫功能有潜在增强。在PA患者中，无论给予天然形式（甲钴胺）还是合成形式（氰钴胺）的维生素B12后，均观察到CD3、CD8+和CD19细胞计数显著恢复。此外，NK细胞活性得到改善，CD4/CD8比值降低。这些发现表明，甲钴胺/氰钴胺有可能显著增强PA患者的免疫力。因此，我们建议采用标准化方法进行精心设计的大规模II期和III期临床试验，以验证这些发现，并为维生素B12对PA患者的免疫调节作用提供更有力的证据。
