SlideShare a Scribd company logo
Domina Petric, MD
Vitamin A: metabolism
Absorption of vitamin A
I.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Absorption of retinoids
• Most of the preformed vitamin A in the
diet is in the form of retinyl esters.
• Retinyl esters are hydrolyzed in the
lumen of the small intestine to yield
retinol.
• This step is catalyzed by hydrolases
produced by the pancreas and situated
on the mucosal brush border or intrinsic
to the brush border itself.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Absorption of retinoids
• The retinyl esters, as well as the carotenoids,
are hydrophobic and, thus, depend on
micellar solubilization for their dispersion in
the aqueous environment of the small
intestinal lumen.
• Vitamin A is poorly utilized from low-fat diets!
• The micellar solubilization of vitamin A
facilitates access of soluble hydrolytic
enzymes to their substrates.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Absorption of retinoids
The overall absorption of retinol from retinyl
esters appears to be fairly high (about 75%).
This process appears to be minimally affected by
the level and type of dietary fat, although the
absorption is appreciably less efficient at very
high vitamin A doses .
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Absorption of retinoids
Vitamin A can also be absorbed via non
lymphatic pathways.
In mammals, the portal system may be an
important alternative route of vitamin A
absorption when the normal lymphatic pathway
is blocked.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Absorption of carotenoids
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Carotenoid metabolism linked
to absorption
• Some carotenoids can be provitamins A because they
can be metabolized to yield retinal due to the action
of retinal-forming carotene dioxygenases.
• Most of this bioconversion occurs via the central
cleavage of the polyene moiety by a predominantly
cytosolic enzyme, β-carotene 15,15′-dioxygenase, found
in the intestinal mucosa, liver and corpus luteum.
• The enzyme requires iron as a cofactor.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Retinoid metabolism linked to
absorption
• Retinal produced by at least the central cleavage step
is reduced in the intestinal mucosa to retinol.
• This step is catalyzed by another enzyme, retinaldehyde
reductase, which is also found in the liver and eye.
• The reduction requires a reduced pyridine nucleotide
(NADH/NADPH) as a cofactor.
• This step can be catalyzed by a short-chain alcohol
dehydrogenase/aldehyde reductase.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Mucosal metabolism of retinol
• Retinol, formed either from the hydrolysis of
dietary retinyl esters or from the reduction of
retinal cleaved from β-carotene, is absorbed
by facilitated diffusion via a specific
transporter.
• Then, retinol is quickly re-esterified with long-
chain fatty acids in the intestinal mucosa.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Mucosal metabolism of retinol
• Vitamin A is transported to the liver mainly (80 to 90% of
a retinol dose) in the form of retinyl esters.
• The composition of lymph retinyl esters is independent
of the fatty acid composition of the most recent meal.
• Retinyl palmitate typically comprises about half of the
total esters.
• Retinyl stearate comprises about a quarter.
• Retinyl oleate and retinyl linoleate are present in small
amounts.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Two pathways for the enzymatic reesterification of
retinol are:
A low-affinity route involves uncomplexed retinol.
• It is catalyzed by acyl-CoA: retinol
acyltransferase.
A high-affinity route involves retinol complexed
with a specific binding protein, cellular retinol-
binding protein type II.
• It is catalyzed by lecithin–retinol acyltransferase.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Vitamin A transport
II.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Retinyl esters
Retinyl esters are secreted from the
intestinal mucosal cells in the hydrophobic
cores of chylomicron particles, by which
absorbed vitamin A is transported to the
liver through the lymphatic circulation,
ultimately entering the plasma
compartment through the thoracic duct.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Transport of carotenoids
Carotenoids that are not
metabolized at the intestinal mucosa
are transported from that organ by
chylomicra via the lymphatic
circulation to the liver, where they
are transferred to lipoproteins.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Transport of carotenoids
The hydrocarbon carotenoids are
transported primarily in low-density
lipoproteins (LDLs).
The more polar carotenoids are transported
in a more evenly distributed manner among
LDLs and high-density lipoproteins (HDLs).
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Transport of carotenoids
β-carotene is retained by the
chylomicron remnants to be
internalized by the liver for
subsequent secretion in very low
density lipoproteins (VLDLs).
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Impact of abetalipoproteinemia
• The absorption of vitamin A (as well as the other fat soluble
vitamins) is a particular problem in patients
with abetalipoproteinemia.
• These patients lack apo B and can not synthesize any of the
apo B-containing lipoproteins: LDLs, VLDLs, chylomicra.
• Having no chylomicra, they show hypolipidemia and low
plasma vitamin A levels.
• When given oral vitamin A supplementation, their plasma
levels are normal.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Storage of vitamin A in the liver
• Newly absorbed retinyl esters are taken up by the
liver in association with chylomicron remnants by
receptor-mediated endocytosis on the part of liver
parenchymal cells.
• Within those cells, remnants are degraded by
lysosomal enzymes.
• Retinol can be transferred from the parenchymal
cells to stellate cells, where it is re-esterified.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Retinyl ester hydrolysis
• Vitamin A is mobilized as retinol from the liver by
hydrolysis of hepatic retinyl esters.
• This mobilization accounts for about 55% of the
retinol discharged to the plasma (the balance
comes from recycling from extrahepatic tissues).
• The retinyl ester hydrolase involved in this
process shows extreme variation between
individuals.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Retinol-binding protein
Once mobilized from liver
stores, retinol is transported to
peripheral tissues by means of a
specific carrier protein, plasma
retinol-binding protein (RBP).
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Transport of retinoids
The transport, storage, and
metabolism of the retinoids involve
their binding to several other binding
proteins, such as cellular retinol-
binding protein types I and II, and
cellular retinoic acid-binding protein
types I and II.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Cellular uptake of retinol
• Due to their hydrophobic character, the
plasma membranes do not present a barrier
to retinol uptake.
• Retinol can enter target cells by nonspecific
partitioning into the plasma membrane from
RBP, but most of the vitamin appears to enter
cells through specific RBP (receptor-mediated
mechanisms).
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Retinol recycling
The majority of retinol
that leaves the plasma
appears to be recycled.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Plasma retinol homeostasis
In healthy individuals,
plasma retinol is maintained
within a narrow range:
40–50 mg/ml in adults.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Vitamin A in adipose tissue
Appreciable amounts
of vitamin A are stored
in adipocytes: 15–20%
of total body store.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Milk retinol
Retinol is transferred
from mother to
infant through milk.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Metabolism of vitamin A
III.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Metabolism of vitamin A
The metabolism of vitamin A centers
around the transport form, retinol, and the
various routes of conversion available to it:
•esterification
•conjugation
•oxidation
•isomerization
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Excretion of vitamin A
IV.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
Excretion of vitamin A
• Vitamin A is excreted in various forms in
both the urine and feces.
• Under normal physiological conditions,
the efficiency of enteric absorption of
vitamin A is high (80–95%), with 30–60%
of the absorbed amount being deposited
in esterified form in the liver.
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
• Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
Literature
4/7/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.

More Related Content

What's hot

BIOTIN (B7)
BIOTIN (B7)BIOTIN (B7)
BIOTIN (B7)
YESANNA
 
Absorption, transport and metabolism of vitamin K
Absorption, transport and metabolism of vitamin KAbsorption, transport and metabolism of vitamin K
Absorption, transport and metabolism of vitamin K
Domina Petric
 
Pantothenic acid(B5)
Pantothenic acid(B5)Pantothenic acid(B5)
Pantothenic acid(B5)
YESANNA
 
NIACIN (B3)
NIACIN (B3)NIACIN (B3)
NIACIN (B3)
YESANNA
 
VITAMIN B1 THIAMINE MUHAMMAD MUSTANSAR
VITAMIN B1  THIAMINE    MUHAMMAD MUSTANSARVITAMIN B1  THIAMINE    MUHAMMAD MUSTANSAR
VITAMIN B1 THIAMINE MUHAMMAD MUSTANSARDr Muhammad Mustansar
 
PYRIDOXINE (B6)
PYRIDOXINE (B6)PYRIDOXINE (B6)
PYRIDOXINE (B6)
YESANNA
 
Vitamin A
Vitamin AVitamin A
Vitamin - A
Vitamin -  AVitamin -  A
Vitamin - A
Ashok Katta
 
Fat soluble vitamines
Fat soluble vitaminesFat soluble vitamines
Fat soluble vitamines
Dr. Vishnu Vrardhan Reddy Pulimi
 
Vitamin b2
Vitamin b2Vitamin b2
Vitamin b2
Bangaluru
 
Thiamine
ThiamineThiamine
Thiamine
Namrata Chhabra
 
Vitamin A chemistry, functions and deficiency
Vitamin A chemistry, functions and deficiencyVitamin A chemistry, functions and deficiency
Vitamin A chemistry, functions and deficiency
Namrata Chhabra
 
Metabolic functions of vitamin A
Metabolic functions of vitamin AMetabolic functions of vitamin A
Metabolic functions of vitamin A
Domina Petric
 
Vitamin b1
Vitamin b1Vitamin b1
Vitamin b1
JasmineJuliet
 
Water soluble vitamins
Water soluble vitaminsWater soluble vitamins
Water soluble vitamins
IAU Dent
 
Vitamin A
Vitamin AVitamin A
Vitamin A
Ansil P N
 
Vitamin E
Vitamin EVitamin E
Vitamin E
YESANNA
 
Water soluble vitamins
Water soluble vitaminsWater soluble vitamins
Water soluble vitamins
Arun Geetha Viswanathan
 

What's hot (20)

BIOTIN (B7)
BIOTIN (B7)BIOTIN (B7)
BIOTIN (B7)
 
Absorption, transport and metabolism of vitamin K
Absorption, transport and metabolism of vitamin KAbsorption, transport and metabolism of vitamin K
Absorption, transport and metabolism of vitamin K
 
Riboflavin ( B2) MUHAMMAD MUSTANSAR
Riboflavin ( B2) MUHAMMAD MUSTANSARRiboflavin ( B2) MUHAMMAD MUSTANSAR
Riboflavin ( B2) MUHAMMAD MUSTANSAR
 
Pantothenic acid(B5)
Pantothenic acid(B5)Pantothenic acid(B5)
Pantothenic acid(B5)
 
NIACIN (B3)
NIACIN (B3)NIACIN (B3)
NIACIN (B3)
 
VITAMIN B1 THIAMINE MUHAMMAD MUSTANSAR
VITAMIN B1  THIAMINE    MUHAMMAD MUSTANSARVITAMIN B1  THIAMINE    MUHAMMAD MUSTANSAR
VITAMIN B1 THIAMINE MUHAMMAD MUSTANSAR
 
PYRIDOXINE (B6)
PYRIDOXINE (B6)PYRIDOXINE (B6)
PYRIDOXINE (B6)
 
Vitamin A
Vitamin AVitamin A
Vitamin A
 
Vitamin - A
Vitamin -  AVitamin -  A
Vitamin - A
 
Fat soluble vitamines
Fat soluble vitaminesFat soluble vitamines
Fat soluble vitamines
 
Vitamin b2
Vitamin b2Vitamin b2
Vitamin b2
 
Thiamine
ThiamineThiamine
Thiamine
 
Vitamin A chemistry, functions and deficiency
Vitamin A chemistry, functions and deficiencyVitamin A chemistry, functions and deficiency
Vitamin A chemistry, functions and deficiency
 
Metabolic functions of vitamin A
Metabolic functions of vitamin AMetabolic functions of vitamin A
Metabolic functions of vitamin A
 
Vitamin b1
Vitamin b1Vitamin b1
Vitamin b1
 
Water soluble vitamins
Water soluble vitaminsWater soluble vitamins
Water soluble vitamins
 
Vitamin A
Vitamin AVitamin A
Vitamin A
 
Vitamin E
Vitamin EVitamin E
Vitamin E
 
Vitamin B12 MUHAMMAD MUSTANSAR
Vitamin   B12   MUHAMMAD MUSTANSARVitamin   B12   MUHAMMAD MUSTANSAR
Vitamin B12 MUHAMMAD MUSTANSAR
 
Water soluble vitamins
Water soluble vitaminsWater soluble vitamins
Water soluble vitamins
 

Similar to Vitamin A metabolism

chapter 5 vitamins.ppt
chapter 5 vitamins.pptchapter 5 vitamins.ppt
chapter 5 vitamins.ppt
Fatima117039
 
Vitamins and eye
Vitamins and eyeVitamins and eye
Vitamins and eye
Arun Geetha Viswanathan
 
Absorption, transport and metabolism of cyanocobalamin
Absorption, transport and metabolism of cyanocobalaminAbsorption, transport and metabolism of cyanocobalamin
Absorption, transport and metabolism of cyanocobalamin
Domina Petric
 
Vitamin A( Animals and HUmans)
Vitamin A( Animals and HUmans)Vitamin A( Animals and HUmans)
Vitamin A( Animals and HUmans)
rajeshneupane00
 
Vitamins
VitaminsVitamins
Vitamin A.pptx
Vitamin A.pptxVitamin A.pptx
Vitamin A.pptx
JasperOmingo
 
Vitamin A deficiency
Vitamin A deficiencyVitamin A deficiency
Vitamin A deficiency
Domina Petric
 
Lec 5, 6 level 4-de (fat soluble vitamins)
Lec 5, 6 level 4-de (fat soluble vitamins)Lec 5, 6 level 4-de (fat soluble vitamins)
Lec 5, 6 level 4-de (fat soluble vitamins)dream10f
 
vitamins.pptx
vitamins.pptxvitamins.pptx
vitamins.pptx
Jyoti Balmiki
 
Absorption, transport and metabolism of pantothenic acid
Absorption, transport and metabolism of pantothenic acidAbsorption, transport and metabolism of pantothenic acid
Absorption, transport and metabolism of pantothenic acid
Domina Petric
 
Lec56 level4-defatsolublevitamins-130202064226-phpapp01
Lec56 level4-defatsolublevitamins-130202064226-phpapp01Lec56 level4-defatsolublevitamins-130202064226-phpapp01
Lec56 level4-defatsolublevitamins-130202064226-phpapp01
Cleophas Rwemera
 
Absorption, transport and metabolism of riboflavin
Absorption, transport and metabolism of riboflavinAbsorption, transport and metabolism of riboflavin
Absorption, transport and metabolism of riboflavin
Domina Petric
 
Fat soluble vitamins
Fat soluble vitaminsFat soluble vitamins
Fat soluble vitamins
Arun Geetha Viswanathan
 
vitaminstypesandfunctions-171022080107 (1).pptx
vitaminstypesandfunctions-171022080107 (1).pptxvitaminstypesandfunctions-171022080107 (1).pptx
vitaminstypesandfunctions-171022080107 (1).pptx
safuraqazi
 
Fat soluble vitamin :Vitamin A
Fat soluble vitamin :Vitamin AFat soluble vitamin :Vitamin A
Fat soluble vitamin :Vitamin A
Koppukonda Shanthi
 
Vitamin A and D
Vitamin A and DVitamin A and D
Vitamin A and D
BiochemistrySGRDIMSAR
 
Water_soluble_VITAMINS.ppt
Water_soluble_VITAMINS.pptWater_soluble_VITAMINS.ppt
Water_soluble_VITAMINS.ppt
Malaz21
 

Similar to Vitamin A metabolism (20)

chapter 5 vitamins.ppt
chapter 5 vitamins.pptchapter 5 vitamins.ppt
chapter 5 vitamins.ppt
 
Vitamins and eye
Vitamins and eyeVitamins and eye
Vitamins and eye
 
Absorption, transport and metabolism of cyanocobalamin
Absorption, transport and metabolism of cyanocobalaminAbsorption, transport and metabolism of cyanocobalamin
Absorption, transport and metabolism of cyanocobalamin
 
Vitamin A( Animals and HUmans)
Vitamin A( Animals and HUmans)Vitamin A( Animals and HUmans)
Vitamin A( Animals and HUmans)
 
Vitamins
VitaminsVitamins
Vitamins
 
Vitamin A.pptx
Vitamin A.pptxVitamin A.pptx
Vitamin A.pptx
 
Vitamin A deficiency
Vitamin A deficiencyVitamin A deficiency
Vitamin A deficiency
 
Lec 5, 6 level 4-de (fat soluble vitamins)
Lec 5, 6 level 4-de (fat soluble vitamins)Lec 5, 6 level 4-de (fat soluble vitamins)
Lec 5, 6 level 4-de (fat soluble vitamins)
 
vitamins.pptx
vitamins.pptxvitamins.pptx
vitamins.pptx
 
Absorption, transport and metabolism of pantothenic acid
Absorption, transport and metabolism of pantothenic acidAbsorption, transport and metabolism of pantothenic acid
Absorption, transport and metabolism of pantothenic acid
 
Lec56 level4-defatsolublevitamins-130202064226-phpapp01
Lec56 level4-defatsolublevitamins-130202064226-phpapp01Lec56 level4-defatsolublevitamins-130202064226-phpapp01
Lec56 level4-defatsolublevitamins-130202064226-phpapp01
 
Absorption, transport and metabolism of riboflavin
Absorption, transport and metabolism of riboflavinAbsorption, transport and metabolism of riboflavin
Absorption, transport and metabolism of riboflavin
 
Fat soluble vitamins
Fat soluble vitaminsFat soluble vitamins
Fat soluble vitamins
 
FAT SOLUBLE VITAMINS A & D
FAT SOLUBLE VITAMINS  A & DFAT SOLUBLE VITAMINS  A & D
FAT SOLUBLE VITAMINS A & D
 
vitaminstypesandfunctions-171022080107 (1).pptx
vitaminstypesandfunctions-171022080107 (1).pptxvitaminstypesandfunctions-171022080107 (1).pptx
vitaminstypesandfunctions-171022080107 (1).pptx
 
FAT SOLUBLE VITAMINS A & D
FAT SOLUBLE VITAMINS  A & DFAT SOLUBLE VITAMINS  A & D
FAT SOLUBLE VITAMINS A & D
 
FAT SOLUBLE VITAMINS A & D
FAT SOLUBLE VITAMINS  A & DFAT SOLUBLE VITAMINS  A & D
FAT SOLUBLE VITAMINS A & D
 
Fat soluble vitamin :Vitamin A
Fat soluble vitamin :Vitamin AFat soluble vitamin :Vitamin A
Fat soluble vitamin :Vitamin A
 
Vitamin A and D
Vitamin A and DVitamin A and D
Vitamin A and D
 
Water_soluble_VITAMINS.ppt
Water_soluble_VITAMINS.pptWater_soluble_VITAMINS.ppt
Water_soluble_VITAMINS.ppt
 

More from Domina Petric

Tetrodotoxin
TetrodotoxinTetrodotoxin
Tetrodotoxin
Domina Petric
 
NOAC
NOACNOAC
ECG S
ECG SECG S
ECG L
ECG LECG L
ECG I
ECG IECG I
ECG H
ECG HECG H
ECG F
ECG FECG F
ECG E
ECG EECG E
ECG D
ECG DECG D
ECG C
ECG CECG C
ECG B
ECG BECG B
ECG A: AVNRT, AVRT
ECG A: AVNRT, AVRTECG A: AVNRT, AVRT
ECG A: AVNRT, AVRT
Domina Petric
 
ECG A: AV blocks
ECG A: AV blocksECG A: AV blocks
ECG A: AV blocks
Domina Petric
 
ECG A: first part.
ECG A: first part.ECG A: first part.
ECG A: first part.
Domina Petric
 
Cardiorenal syndrome
Cardiorenal syndromeCardiorenal syndrome
Cardiorenal syndrome
Domina Petric
 
Categorization of risks and benefits (food additives)
Categorization of risks and benefits (food additives)Categorization of risks and benefits (food additives)
Categorization of risks and benefits (food additives)
Domina Petric
 
Benefits and risks of additives
Benefits and risks of additivesBenefits and risks of additives
Benefits and risks of additives
Domina Petric
 
Types of food additives
Types of food additivesTypes of food additives
Types of food additives
Domina Petric
 
Effector phase in immune mediated drug hypersensitivity
Effector phase in immune mediated drug hypersensitivityEffector phase in immune mediated drug hypersensitivity
Effector phase in immune mediated drug hypersensitivity
Domina Petric
 
T cell stimulation by drugs
T cell stimulation by drugsT cell stimulation by drugs
T cell stimulation by drugs
Domina Petric
 

More from Domina Petric (20)

Tetrodotoxin
TetrodotoxinTetrodotoxin
Tetrodotoxin
 
NOAC
NOACNOAC
NOAC
 
ECG S
ECG SECG S
ECG S
 
ECG L
ECG LECG L
ECG L
 
ECG I
ECG IECG I
ECG I
 
ECG H
ECG HECG H
ECG H
 
ECG F
ECG FECG F
ECG F
 
ECG E
ECG EECG E
ECG E
 
ECG D
ECG DECG D
ECG D
 
ECG C
ECG CECG C
ECG C
 
ECG B
ECG BECG B
ECG B
 
ECG A: AVNRT, AVRT
ECG A: AVNRT, AVRTECG A: AVNRT, AVRT
ECG A: AVNRT, AVRT
 
ECG A: AV blocks
ECG A: AV blocksECG A: AV blocks
ECG A: AV blocks
 
ECG A: first part.
ECG A: first part.ECG A: first part.
ECG A: first part.
 
Cardiorenal syndrome
Cardiorenal syndromeCardiorenal syndrome
Cardiorenal syndrome
 
Categorization of risks and benefits (food additives)
Categorization of risks and benefits (food additives)Categorization of risks and benefits (food additives)
Categorization of risks and benefits (food additives)
 
Benefits and risks of additives
Benefits and risks of additivesBenefits and risks of additives
Benefits and risks of additives
 
Types of food additives
Types of food additivesTypes of food additives
Types of food additives
 
Effector phase in immune mediated drug hypersensitivity
Effector phase in immune mediated drug hypersensitivityEffector phase in immune mediated drug hypersensitivity
Effector phase in immune mediated drug hypersensitivity
 
T cell stimulation by drugs
T cell stimulation by drugsT cell stimulation by drugs
T cell stimulation by drugs
 

Recently uploaded

SURGICAL ANATOMY OF THE RETROPERITONEUM, ADRENALS, KIDNEYS AND URETERS.pptx
SURGICAL ANATOMY OF THE RETROPERITONEUM, ADRENALS, KIDNEYS AND URETERS.pptxSURGICAL ANATOMY OF THE RETROPERITONEUM, ADRENALS, KIDNEYS AND URETERS.pptx
SURGICAL ANATOMY OF THE RETROPERITONEUM, ADRENALS, KIDNEYS AND URETERS.pptx
Bright Chipili
 
CDSCO and Phamacovigilance {Regulatory body in India}
CDSCO and Phamacovigilance {Regulatory body in India}CDSCO and Phamacovigilance {Regulatory body in India}
CDSCO and Phamacovigilance {Regulatory body in India}
NEHA GUPTA
 
Top-Vitamin-Supplement-Brands-in-India.pptx
Top-Vitamin-Supplement-Brands-in-India.pptxTop-Vitamin-Supplement-Brands-in-India.pptx
Top-Vitamin-Supplement-Brands-in-India.pptx
SwisschemDerma
 
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptxPharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
Physiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdfPhysiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdf
MedicoseAcademics
 
Knee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdfKnee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdf
vimalpl1234
 
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Ocular injury  ppt  Upendra pal  optometrist upums saifai etawahOcular injury  ppt  Upendra pal  optometrist upums saifai etawah
Ocular injury ppt Upendra pal optometrist upums saifai etawah
pal078100
 
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Basavarajeeyam - Ayurvedic heritage book of Andhra pradeshBasavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Dr. Madduru Muni Haritha
 
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.GawadHemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
NephroTube - Dr.Gawad
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
addon Scans
 
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Novas diretrizes da OMS para os cuidados perinatais de mais qualidadeNovas diretrizes da OMS para os cuidados perinatais de mais qualidade
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Prof. Marcus Renato de Carvalho
 
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptxHow STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
FFragrant
 
Role of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of HyperthyroidismRole of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of Hyperthyroidism
Dr. Jyothirmai Paindla
 
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in IndiaTop 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in India
SwastikAyurveda
 
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness JourneyTom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
greendigital
 
Physiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of TastePhysiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of Taste
MedicoseAcademics
 
Vision-1.pptx, Eye structure, basics of optics
Vision-1.pptx, Eye structure, basics of opticsVision-1.pptx, Eye structure, basics of optics
Vision-1.pptx, Eye structure, basics of optics
Sai Sailesh Kumar Goothy
 
KDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologistsKDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologists
د.محمود نجيب
 
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptxThyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Oleg Kshivets
 

Recently uploaded (20)

SURGICAL ANATOMY OF THE RETROPERITONEUM, ADRENALS, KIDNEYS AND URETERS.pptx
SURGICAL ANATOMY OF THE RETROPERITONEUM, ADRENALS, KIDNEYS AND URETERS.pptxSURGICAL ANATOMY OF THE RETROPERITONEUM, ADRENALS, KIDNEYS AND URETERS.pptx
SURGICAL ANATOMY OF THE RETROPERITONEUM, ADRENALS, KIDNEYS AND URETERS.pptx
 
CDSCO and Phamacovigilance {Regulatory body in India}
CDSCO and Phamacovigilance {Regulatory body in India}CDSCO and Phamacovigilance {Regulatory body in India}
CDSCO and Phamacovigilance {Regulatory body in India}
 
Top-Vitamin-Supplement-Brands-in-India.pptx
Top-Vitamin-Supplement-Brands-in-India.pptxTop-Vitamin-Supplement-Brands-in-India.pptx
Top-Vitamin-Supplement-Brands-in-India.pptx
 
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptxPharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
 
Physiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdfPhysiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdf
 
Knee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdfKnee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdf
 
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Ocular injury  ppt  Upendra pal  optometrist upums saifai etawahOcular injury  ppt  Upendra pal  optometrist upums saifai etawah
Ocular injury ppt Upendra pal optometrist upums saifai etawah
 
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Basavarajeeyam - Ayurvedic heritage book of Andhra pradeshBasavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
 
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.GawadHemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
 
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Novas diretrizes da OMS para os cuidados perinatais de mais qualidadeNovas diretrizes da OMS para os cuidados perinatais de mais qualidade
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
 
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptxHow STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
 
Role of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of HyperthyroidismRole of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of Hyperthyroidism
 
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in IndiaTop 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in India
 
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness JourneyTom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
 
Physiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of TastePhysiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of Taste
 
Vision-1.pptx, Eye structure, basics of optics
Vision-1.pptx, Eye structure, basics of opticsVision-1.pptx, Eye structure, basics of optics
Vision-1.pptx, Eye structure, basics of optics
 
KDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologistsKDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologists
 
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptxThyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
 
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
 

Vitamin A metabolism

  • 2. Absorption of vitamin A I. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 3. Absorption of retinoids • Most of the preformed vitamin A in the diet is in the form of retinyl esters. • Retinyl esters are hydrolyzed in the lumen of the small intestine to yield retinol. • This step is catalyzed by hydrolases produced by the pancreas and situated on the mucosal brush border or intrinsic to the brush border itself. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 4. Absorption of retinoids • The retinyl esters, as well as the carotenoids, are hydrophobic and, thus, depend on micellar solubilization for their dispersion in the aqueous environment of the small intestinal lumen. • Vitamin A is poorly utilized from low-fat diets! • The micellar solubilization of vitamin A facilitates access of soluble hydrolytic enzymes to their substrates. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 5. Absorption of retinoids The overall absorption of retinol from retinyl esters appears to be fairly high (about 75%). This process appears to be minimally affected by the level and type of dietary fat, although the absorption is appreciably less efficient at very high vitamin A doses . 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 6. Absorption of retinoids Vitamin A can also be absorbed via non lymphatic pathways. In mammals, the portal system may be an important alternative route of vitamin A absorption when the normal lymphatic pathway is blocked. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 7. Absorption of carotenoids 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 8. Carotenoid metabolism linked to absorption • Some carotenoids can be provitamins A because they can be metabolized to yield retinal due to the action of retinal-forming carotene dioxygenases. • Most of this bioconversion occurs via the central cleavage of the polyene moiety by a predominantly cytosolic enzyme, β-carotene 15,15′-dioxygenase, found in the intestinal mucosa, liver and corpus luteum. • The enzyme requires iron as a cofactor. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 9. Retinoid metabolism linked to absorption • Retinal produced by at least the central cleavage step is reduced in the intestinal mucosa to retinol. • This step is catalyzed by another enzyme, retinaldehyde reductase, which is also found in the liver and eye. • The reduction requires a reduced pyridine nucleotide (NADH/NADPH) as a cofactor. • This step can be catalyzed by a short-chain alcohol dehydrogenase/aldehyde reductase. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 10. Mucosal metabolism of retinol • Retinol, formed either from the hydrolysis of dietary retinyl esters or from the reduction of retinal cleaved from β-carotene, is absorbed by facilitated diffusion via a specific transporter. • Then, retinol is quickly re-esterified with long- chain fatty acids in the intestinal mucosa. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 11. Mucosal metabolism of retinol • Vitamin A is transported to the liver mainly (80 to 90% of a retinol dose) in the form of retinyl esters. • The composition of lymph retinyl esters is independent of the fatty acid composition of the most recent meal. • Retinyl palmitate typically comprises about half of the total esters. • Retinyl stearate comprises about a quarter. • Retinyl oleate and retinyl linoleate are present in small amounts. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 12. Two pathways for the enzymatic reesterification of retinol are: A low-affinity route involves uncomplexed retinol. • It is catalyzed by acyl-CoA: retinol acyltransferase. A high-affinity route involves retinol complexed with a specific binding protein, cellular retinol- binding protein type II. • It is catalyzed by lecithin–retinol acyltransferase. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 13. Vitamin A transport II. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 14. Retinyl esters Retinyl esters are secreted from the intestinal mucosal cells in the hydrophobic cores of chylomicron particles, by which absorbed vitamin A is transported to the liver through the lymphatic circulation, ultimately entering the plasma compartment through the thoracic duct. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 15. Transport of carotenoids Carotenoids that are not metabolized at the intestinal mucosa are transported from that organ by chylomicra via the lymphatic circulation to the liver, where they are transferred to lipoproteins. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 16. Transport of carotenoids The hydrocarbon carotenoids are transported primarily in low-density lipoproteins (LDLs). The more polar carotenoids are transported in a more evenly distributed manner among LDLs and high-density lipoproteins (HDLs). 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 17. Transport of carotenoids β-carotene is retained by the chylomicron remnants to be internalized by the liver for subsequent secretion in very low density lipoproteins (VLDLs). 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 18. Impact of abetalipoproteinemia • The absorption of vitamin A (as well as the other fat soluble vitamins) is a particular problem in patients with abetalipoproteinemia. • These patients lack apo B and can not synthesize any of the apo B-containing lipoproteins: LDLs, VLDLs, chylomicra. • Having no chylomicra, they show hypolipidemia and low plasma vitamin A levels. • When given oral vitamin A supplementation, their plasma levels are normal. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 19. Storage of vitamin A in the liver • Newly absorbed retinyl esters are taken up by the liver in association with chylomicron remnants by receptor-mediated endocytosis on the part of liver parenchymal cells. • Within those cells, remnants are degraded by lysosomal enzymes. • Retinol can be transferred from the parenchymal cells to stellate cells, where it is re-esterified. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 20. Retinyl ester hydrolysis • Vitamin A is mobilized as retinol from the liver by hydrolysis of hepatic retinyl esters. • This mobilization accounts for about 55% of the retinol discharged to the plasma (the balance comes from recycling from extrahepatic tissues). • The retinyl ester hydrolase involved in this process shows extreme variation between individuals. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 21. Retinol-binding protein Once mobilized from liver stores, retinol is transported to peripheral tissues by means of a specific carrier protein, plasma retinol-binding protein (RBP). 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 22. Transport of retinoids The transport, storage, and metabolism of the retinoids involve their binding to several other binding proteins, such as cellular retinol- binding protein types I and II, and cellular retinoic acid-binding protein types I and II. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 23. Cellular uptake of retinol • Due to their hydrophobic character, the plasma membranes do not present a barrier to retinol uptake. • Retinol can enter target cells by nonspecific partitioning into the plasma membrane from RBP, but most of the vitamin appears to enter cells through specific RBP (receptor-mediated mechanisms). 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 24. Retinol recycling The majority of retinol that leaves the plasma appears to be recycled. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 25. Plasma retinol homeostasis In healthy individuals, plasma retinol is maintained within a narrow range: 40–50 mg/ml in adults. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 26. Vitamin A in adipose tissue Appreciable amounts of vitamin A are stored in adipocytes: 15–20% of total body store. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 27. Milk retinol Retinol is transferred from mother to infant through milk. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 28. Metabolism of vitamin A III. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 29. Metabolism of vitamin A The metabolism of vitamin A centers around the transport form, retinol, and the various routes of conversion available to it: •esterification •conjugation •oxidation •isomerization 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 30. Excretion of vitamin A IV. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 31. Excretion of vitamin A • Vitamin A is excreted in various forms in both the urine and feces. • Under normal physiological conditions, the efficiency of enteric absorption of vitamin A is high (80–95%), with 30–60% of the absorbed amount being deposited in esterified form in the liver. 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.
  • 32. • Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. Literature 4/7/2018 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008.