title: Effects of cyanocobalamin on immunity in patients with pernicious anemia.
abstract: OBJECTIVE
  The aim of the study was to evaluate the role of vitamin B(12) in patients with pernicious anemia.
  
  
  METHODS
  This study was conducted prospectively at the Turgut Ozal Medical Center, Department of Hematology, between April and November 2002. Absolute numbers and ratio of the surface antigens of T and B lymphocyte subgroups, CD4/CD8 ratio were calculated in order to evaluate changes in leukocyte and lymphocyte numbers; natural killer (NK) cell count, serum C3, C4, and levels of immunoglobulins G, A, and M were also measured to evaluate vitamin B(12) effect on immunity. Values obtained before treatment with cyanocobalamin were compared with those found during peak reticulocyte count.
  
  
  RESULTS
  In vitamin B(12)-deficient patients, absolute numbers of CD4+ and especially CD8+ lymphocytes were found to be decreased; CD4/CD8 ratio increased, and NK cell activity was depressed. After cyanocobalamin treatment, absolute numbers and percentage of lymphocyte subgroups were elevated. Increased CD4/CD8 ratio and depressed NK cell activity were restored and levels of C3, C4, and immunoglobulins were elevated.
  
  
  CONCLUSIONS
  These findings suggest that vitamin B(12) has important immunomodulatory effects on cellular immunity, and abnormalities in the immune system in pernicious anemia are restored by vitamin B(12) replacement therapy.
authors.affiliation: Department of Hematology, Faculty of Medicine, Inonu University, Malatya, Turkey. maerkurt@inonu.edu.tr
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Erkurt
authors.forename: Ismet
authors.initials: I
authors.lastname: Aydogdu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Dikilitaş
authors.forename: Irfan
authors.initials: I
authors.lastname: Kuku
authors.forename: Emin
authors.initials: E
authors.lastname: Kaya
authors.forename: Nihayet
authors.initials: N
authors.lastname: Bayraktar
authors.forename: Onur
authors.initials: O
authors.lastname: Ozhan
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ozkan
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sonmez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000752:Anemia, Pernicious / Q000188:drug therapy* / Q000276:immunology*; D016516:CD4-CD8 Ratio; D003165:Complement System Proteins / Q000187:drug effects / Q000378:metabolism; D005260:Female; D006801:Humans; D007109:Immunity / Q000187:drug effects*; D007136:Immunoglobulins / Q000187:drug effects / Q000378:metabolism; D016131:Lymphocyte Subsets / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014805:Vitamin B 12 / Q000494:pharmacology*
chemical_list: D007136:Immunoglobulins; D003165:Complement System Proteins; D014805:Vitamin B 12