Kass L
Am J Clin Pathol. 1976 Apr;65(4):504-7. doi: 10.1093/ajcp/65.4.504.
Utilizing a bacterial-agar overlay technic incorporating the methionine-requiring bacterium Leukonostoc mesenteroides, little or no bacterial growth was seen surrounding the megaloblasts and proerythroblasts of eight patients who had severe untreated pernicious anemia. Similarly, scant bacterial growth was observed in five cases of chronic erythremic myelosis (DiGuglielmo syndrome). Heavy bacterial growth, indicating ample amounts of methionine, was seen in two cases of autoimmune hemolytic anemia, and in two cases of severe untreated folate-deficiency anemia. The results are consistent with the "methyltetrahydrofolate trap" hypothesis in pernicious anemia, in which a defect in the methylcobalamin-dependent methyltransferase leads to reduced amounts of methionine. These studies also suggest that a similar methyltransferase defect does not occur in folate deficiency or autoimmune hemolytic anemia. The generation of methionine, as estimated by the present technic, may also be defective in chronic erythremic myelosis.
利用一种细菌 - 琼脂覆盖技术，该技术采用了需要甲硫氨酸的肠膜明串珠菌，在8例未经治疗的严重恶性贫血患者的巨幼红细胞和早幼红细胞周围几乎未见细菌生长。同样，在5例慢性红血病性骨髓增生症（迪古列尔莫综合征）病例中观察到细菌生长稀少。在2例自身免疫性溶血性贫血病例和2例未经治疗的严重叶酸缺乏性贫血病例中，观察到大量细菌生长，表明存在大量甲硫氨酸。这些结果与恶性贫血中的“甲基四氢叶酸陷阱”假说一致，即钴胺素依赖性甲基转移酶缺陷导致甲硫氨酸量减少。这些研究还表明，在叶酸缺乏或自身免疫性溶血性贫血中不会出现类似的甲基转移酶缺陷。根据目前的技术估计，慢性红血病性骨髓增生症中甲硫氨酸的生成也可能存在缺陷。
