Beriberi is the result of thiamine deficiency (TD), causing neurological and cardiovascular disease. TD causes a reduction in the ability of heart muscle to contract. Thiamine is a cofactor for a number of metabolic enzymes, and while much research has focused on the nervous system effects of beriberi, little is known about the effects on the heart. TD is reported to cause heart failure, but little is known about the mechanism. TPP (thiamine pyrophosphate) is the biologically active form of thiamine in the body and is a cofactor for various enzymes.
Rats fed a TD diet for 35 days underwent extensive blood testing while on the diet. The animals were dissected and the hearts were studied. They were found to have whole body deficiency of oxygen consumption and increased lactate levels. Low oxygen consumption often causes increased lactate levels.
Reactive oxygen species (ROS), superoxide and H2O2 (hydrogen peroxide) were measured at the cellular levels in the heart muscles. Superoxide levels were increased by 40% and H2O2 levels were 2.5 times normal, consistent with damage to the cells. ROS results from a disruption in oxygen metabolism as was seen above.
Antioxidants are the defense against ROS. SOD (superoxide dismutase) is an antioxidant which works against the ROS superoxide. Antioxidant enzyme activity was tested to check for the response to this strong oxidation. The proper proteins were produced, but this did not result in increased SOD enzyme activity in the cells. The SOD enzyme should modulate the superoxide, but could not do so in the TD cells. Importantly, TD cells had very high levels of oxidative stress (measured by MDA).
Maintaining a low level of H2O2 cells is important and is the job of glutathione peroxidase (GPx) and catalase enzymes. All cells are sensitive to H2O2, but heart cells are especially sensitive. The TD cardiac cells were found to have low levels of GPx as compared to control cells and elevated levels of catalase compared.
Studies were done to see if the TD cardiac cells had high frequency of apoptosis (natural cell death by suicide). TD was found to increase cardiac apoptosis.
CONCLUSION: Beriberi from thiamine deficiency can cause heart failure. It produces reduced oxygen consumption and lactic acidosis. That increases the formation of free radicals which should be compensated by natural antioxidants in cells. TD reduces the ability of those antioxidants to do the job, with resulting death of heart muscle cells and heart failure.
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PMID: 20304817. Summary #964. nutrientmedicine