SEMINAR BY: DR.

KRISHI MOHAN INTERN (2006 BATCH)

y Introduction y Definition y Classification y Vitamin A y Vitamin D y Vitamin E y Vitamin K y Bibliography

y These are essential organic substances y Yield no energy, but facilitate energy-yielding chemical reactions y If absent from a diet, it will produce deficiency signs and

symptoms y Fat-soluble vitamins A, D, E, K y Water-soluble vitamins B1 (Thiamin), B2 (Riboflavin), B3 (Niacin), B5 (Panthothenic acid), B6 (Pyridoxine), B9 (Biotin), B12 (Cyanocobalamin ), Folic acid and Vitamin C y Preservation of vitamins in foods
y

exposure to light, heat, air, water, and alkaline

y Vitamins may be regarded as organic compounds

required in the diet in small amounts to perform specific biological functions for normal maintenance of optimal growth and health of the organism

VITAMINS FAT SOLUBLE VITAMIN A VITAMIN D VITAMIN E VITAMIN K NON B- COMPLEX VITAMIN C WATER SOLUBLE B COMPLEX
ENERGY RELEASING

HAEMATOPOIETIC

THIAMINE B1
RIBOFLAVIN B2

FOLIC ACID
CYANOCOBALAMIN B12

NIACIN B3
PYRIDOXINE B6

BIOTIN B7
PANTOTHENIC ACID

y found in fats and oils y require bile for absorption y enter the lymph, then the blood y dissolve in organic solvents y not readily excreted; can cause toxicity y transported like fat in chylomicrons, VLDL, LDL y held and stored in fatty tissues
y daily requirements need not be met

y 3 forms in the body y retinol y retinal y retinoic acid y collectively known as retinoids y found in food derived from animals

Retinol, the alcohol form

Retinal, the aldehyde form

Retinoic acid, the acid form

Cleavage at this point can yield two molecules of vitamin A*

Beta-carotene, a precursor

y Preformed
y Liver, fish oils, fortified milk, eggs y Contributes to half of all the

vitamin A intake
y Proformed
y Dark leafy green , yellow-orange

vegetables/fruits y Contributes to half of all the vitamin A intake

The variety of functions performed by Vitamin A are, 1. Vision y Vision: The biochemical function for the same was elucidated by George Wald (Nobel Prize 1968). y The event occur in a cyclic process known as Rhodopsin Cycle or Wald s Visual Cycle.

Intestinal cell carotene Retina Retinal Retinol FFA Retinylesters Diet carotene Retinylesters FFA Retinol All-trans retinol All-trans retinal Visual cycle

Chylomicrons Target cell Retinol RBP Retinol Retinol Retinoic acid RBP RBP

Liver: All-trans retinol Retinyl palmitate (stored)

mRNA Specific proteins Cell differentiation

y y y y y y y

Vision is based on absorption of light by photoreceptor cells in the eye. Vertebrates have two kinds of photoreceptor cell, called rods & cones because of their distinctive shape. Cones(300million)function in bright light and are responsible for color vision. Rods(100 million) function in dim light but do not perceive color. Rods contain photoreceptor molecules called rhodopsin Rhodopsin consists of a protein opsin linked to 11-cis retinal (a prosthetic gp) which gives the rhodopsin its ability to absorb light. Absorbtion of light result in the isomerization of 11-cis retinal into alltrans retinal.

y Promote vision (retinal) y Maintenance of the cornea y Converting light energy into nerve impulses y Participate in protein synthesis and cell differentiation y Differentiation of epithelial and goblet cells y y y y y

(retinoic acid) Support reproduction and growth Support immunity (retinoic acid and carotenoids) Involved in bone growth and remodeling Synthesis of glycoproteins Antioxidant activity ( -carotene)

2. Retinol and retinoic acid function almost like

steroid hormones. They regulate protein synthesis and thus are involved in cell growth and differentiation. 3. It is essential to maintain healthy epithelial tissue, because retinol and retinoic acid are required to prevent keratin synthesis. Further, retinyl phosphate is essential for the formation of mucopolysaccharides compounds of mucus secreted by epithelial cells to maintain moist surface.

4. Retinyl phosphate synthesized from retinol is

necessary for the synthesis of certain glycoprotein required for growth and mucus secretion. 5. Retinol and retinoic acid are involved in the synthesis of transferrin, the iron transport protein. 6. Vitamin A is considered to be essential for the maintenance of proper immune system to fight against various infections.

7. Cholestrol synthesis requires Vitamin A.

Mevalonate, an intermediate in the cholestrol biosynthesis, is diverted for the synthesis of coenzyme Q in Vitamin A deficiency. 8. Carotenoids ( most important carotene) function as antioxidants and reduce the risk of cancers initiated by free radicals and strong oxidants. carotene is found to be beneficial to prevent heart attacks. This is also attributed to the antioxidant property. 9. Decrease in gluconeogenesis in Vitamin A deficiency is observed which is secondary to the reduced synthesis of glucocorticoids.

Vitamin A - Deficiency
Night blindness: Leading cause of blindness in third world countries

In dim light, you can make out the details in this room. You are using your rods for vision

A flash of bright light momentarily blinds you as the pigment in the rods is bleached.

You quickly recover and can see the details again in a few seconds.

With inadequate vitamin A, you do not recover but remain blinded for many seconds.

y Cell keratinization y Dry skin y Xerophthalmia (dryness of cornea & conjunctiva)

curable early stage after 8 days vitamin A incurable late stages

y Reproductive failure

In females: Increased abortions Neonates born dead/weak Deformed young: no eyeballs; hydrocephalus In males: Keratinization of testicular epithelium y Abnormal skeletal development/maintenance y Immune dysfunction

y Hyperkeratosis and hyperplasia of gingival tissues y Hypoplastic and chalky white incisors y Atrophy of odontoblasts y Atrophy of salivary glands leading to xerostomia causing y y y y y y

increase in caries Crowding of teeth Stunting and thickening of the roots Dental caries Disturbances in differentiation and function of ameloblasts Thick, regular labial dentin with interglobular spaces Thin, atubular lingual dentin

y Cleft lip and palate y Xerostomia y Epithelial metaplasia y Oral leukoplakia

y Upper safe levels are 4- to 10-fold higher than

requirements in nonruminants and 30-50-fold higher than requirements in ruminants y Not readily excreted y Hypervitaminosis A in humans
y Polar explorers eating polar bear or seal liver y Self-medication and overprescription

y Skeletal malformations,

spontaneous fractures, internal hemorrhages y Overconsumption of beta carotene from food sources may cause skin to turn yellow but is not harmful y Birth defects and miscarriage y Decalcification, joint pain, fragility
y Destruction of epiphyseal

cartilage and bone matrix

y Dry itchy skin (caution about

acne treatments) y Hair loss y Liver damage

y Prohormone y Derived from cholesterol y Synthesis from sun exposure y Insufficient sun exposure causes deficiency of the

vitamin y Activated by enzymes in liver and kidneys y Deficiency can cause diseases

y Not always essential

y Body can make it if

exposed to enough sunlight y Made from cholesterol in the skin

y Not found naturally in

many foods y Synthesized in body y Plants (ergosterol)

y

Sun-cured forages

y Fluid milk products are y y y y y

fortified with vitamin D Oily fish Egg yolk Butter Liver Difficult for vegetarians

y Vitamin D = calciferol y Vitamin D2 = ergocalciferol y Completely synthetic form produced by the irradiation of the plant steroid ergosterol y Plant source cannot be used by birds y Vitamin D3 = cholecalciferol y Produced photochemically by the action of sunlight or ultraviolet light from the precursor sterol 7dehydrocholesterol y Animal source required by birds

y 5 ug/d (200 IU/day) for adults under age 51 y 10-15 ug/day (400 - 600 IU/day) for older Americans y Light skinned individuals can produce enough vitamin

D to meet the AI from casual sun exposure y Infant are born with enough vitamin D to last ~9 months of age.

y Functions y Bone development

Calcium absorption (small intestine) y Calcium resorption (bone and kidney) y Maintain blood calcium levels y Phosphorus absorption (small intestine)
y

y Hormone y Regulation of gene expression y Cell growth

y Osteoclasts y Break down bone

y Calcium resorption

Derived from stem cells

y Differentiate after stimulation by vitamin D

y Osteoblasts y Bone-forming cells y Secrete collagen, which calcifies y Bone contains 60 66% Ca by weight y Hydroxyapatite, Ca10(PO4)6(OH)2

y Younger age group y Rickets

y Failure of bones to grow properly y Results in bowed legs or knock-

knees, outward bowed chest and knobs on ribs

y Older age group y Osteomalacia: Adult form of rickets

y Softening of bones, bending of spine,

and bowing of legs

y

Osteoporosis (porous bones):

y Vitamin D plays a major role along

with calcium y Loss of vitamin D activity with advancing age y Associated with fractures very serious for geriatrics

y Hypoplasia and hypocalcification of enamel and dentin y Calciotraumatic line seen during dentin formation is the y y y y y y y

earliest sign of deficiency. Hypomineralized dentin Increased width to predentin Odontoblastic disorganization Enlarged pulp and pulp horns Tooth defects more severe in males Permanent teeth affected predominantly Short, wedge shaped roots with delayed apical closure

y Interglobular calcification in dentin, especially at y y y y y y y y

apices Enamel hypoplasia Enlarged pulp chambers Irregular dentinal tubules Small crowns and short blunted roots Pitted enamel surfaces Retarded jaw, tooth and condyle development Generalized jaw bone resorption Loss of the periodontal ligament

y Calcification of soft tissue y Lungs, heart, blood vessels y Hardening of arteries (calcification) y Hypercalcemia y Normal is ~ 10 mg/dl y Excess blood calcium leads to stone formation in kidneys y Lack of appetite y Excessive thirst and urination

Type II (age-related) osteoporosis

y Loss of bone mass y Limited ability to absorb vitamin D or produce it y 10-20 ug vitamin D/ day plus calcium decrease bone

fracture y Risk for hypercalcemia

Psoriasis
y Skin disorder y Topical treatment

y Tocopherols y Amount absorbed is dependent on fat intake y Incorporated into micelles y Requires bile and fat digesting enzymes y Transported via chylomicrons to the liver y Transported via VLDL, LDL, HDL from the liver y Found concentrated in areas where fat is found y Excreted via bile and urine (much in feces due to

limited absorption)

y Plant oils y Wheat germ y Asparagus y Peanuts y Margarine y Nuts and seeds y Actual amount is

dependent on harvesting, processing, storage and cooking

y Antioxidant y Free radical scavenger

y Protects cell membranes y Protects LDL from oxidation y Protection of double bonds in

polyunsaturated fatty acids y Prevention of rancidity y Works in conjunction with selenium

Protects lungs from pollutants y Protects DNA y Protects heart

y

y Protects the double bonds in saturated fat y Role in iron metabolism y Inhibits LDL oxidation y Inhibits protein kinase C activity y Enhance release of prostacyclin y Maintenance of nervous tissue and immune function y No specific role in metabolic reaction

y 15 mg/day for women and men y (=22 IU of natural source or 33 IU of synthetic form) y Average intake meets RDA

y Reproductive failure y Embryonic degeneration y Ovarian failure y Testes degeneration y Fetal resorption y Derangement of cell permeability y Liver, brain, kidney, or blood capillaries y Brain necrosis (crazy chick disease) y Muscular lesions y White muscle disease (calves, lamb) y Mulberry disease (pigs) y Stiff lamb disease (skeletal muscle degeneration) y Failure to growth

y Disarrangement of ameloblasts y Chalky white teeth

y Supplements up to 800 IU is probably harmless y Upper Level is 1,000 mg/day of any form of

supplementary alpha-tocopherol y Upper Level is 1500 IU (natural sources) or 1100 IU (synthetic forms) y Inhibit vitamin K metabolism and anticoagulants

y 40%-80% of dietary vitamin K is absorbed y Absorption requires bile and pancreatic enzymes y Role in the coagulation process y Calcium-binding potential

y Liver y Green leafy vegetables y Broccoli y Peas y Green beans y Resistant to cooking losses y Limited vitamin K stored

in the body

y K1, phylloquinone y Chloroplasts in plants y K2, menaquinone y Bacterial synthesis y K3, menadione y Synthetic, water soluble form y Complexed to improve stability

Clotting factors are synthesized in the liver as inactive precursors - vitamin K converts them to their active forms
y Conversion of prothrombin to

thrombin, an active enzyme y Formation of fibrinogen to fibrin, leading to clot formation

y Stimulates bone formation and

decreases bone resorption

y 90 ug/day for women y 120 ug/day for men y RDA met by most y Excess vitamins A and E interferes with vitamin K y Newborns are injected with vitamin K(breast milk is a

poor source) y Toxicity unlikely; readily excreted

y Primary deficiency rare; secondary deficiency

occurs when fat absorption is impaired (e.g., cystic fibrosis, Crohn s disease) or following long-term or high-dose administration of antibiotics (they kill the bacteria in large intestine)
y Newborn babies with sterile GI tract; single vitamin K

dose given to prevent hemorrhage

y Prolonged clotting time y Generalized hemorrhages

y Excessive gingival bleeding y Dental caries

y Not common except with over-supplementation

y Phylloquinone and menaquinone are relatively nontoxic y Jaundice; brain damage y Menadione toxic to skin and respiratory tract in high

doses

y A textbook of biochemistry by Satyanarayan. y A textbook of preventive and community denistry by y y y y y

S. S. Hiremath Nutrition and clinical dentristry (3rd edition) by Abraham E. Nizel and Athena S. Papaz Pediatric dentistry (2nd edition) by Pinkham A textbook of public health dentistry by C. M. Marya Textbook of Community Dentistry by Satish Chandra and Shaleen Chandra www.4shared.com