Bertolini S, et al. Lipoprotein Changes Induced by Pantethine in Hyperlipoproteinemic Patients: Adults and Children. Int J Clin Pharmacol Ther Toxicol. Nov1986;24(11):630-37.
Following a brief outline of current knowledge concerning atherosclerosis and its treatment, the authors describe the results obtained by treating with pantethine (900-1200 mg daily for 3 to 6 months) a series of 7 children and 65 adults suffering from hypercholesterolemia alone or associated with hypertriglyceridemia (types IIa and IIb of Fredrickson’s classification). Pantethine treatment produced significant reduction of the better known risk factors (total cholesterol, LDL-cholesterol, triglycerides, and apo- B) and a significant increase of HDL-cholesterol (signally HDL2) and apolipoprotein A-I. The authors conclude with a discussion of these results and of the possible role of pantethine in the treatment of hyperlipoproteinemia, in view of its perfect tolerability and demonstrated therapeutic effectiveness.
Donati C, et al. Pantethine, Diabetes Mellitus and Atherosclerosis. Clinical Study of 1045 Patients. Clin Ter. Mar1989;128(6):411-22.
After a review of the clinical studies on the treatment of diabetic patients with pantethine, the authors discuss the results obtained in a postmarketing surveillance (PMS) study on 1045 hyperlipidemic patients receiving pantethine (900 mg/day on average). Of these patients, 57 were insulin-dependent (Type I) and 241 were non insulin- dependent (Type II) diabetics. Beyond the epidemiological considerations made possible by a PMS study, the authors show that pantethine brought about a statistically significant and comparable improvement of lipid metabolism in the three groups of patients, with very good tolerability. Pantethine should therefore be considered for the treatment of lipid abnormalities also in patients at risk such as those with diabetes mellitus.
Coronel F, et al. Treatment of hyperlipemia in diabetic patients on dialysis with a physiological substance. Am J Nephrol. 1991;11(1):32-6.
Hyperlipemia is a very frequent complication of the diabetic patient on dialysis. There is difficulty of treatment with the diet, because the dietary restriction already imposed on these patients and the secondary effects and toxicity of the available drugs in uremics aggravate the problem. We have treated 22 diabetic patients on dialysis (8 on hemodialysis and 14 on continuous ambulatory peritoneal dialysis) suffering from hyperlipemia with pantethine, a physiological substance and coenzyme A precursor in the Krebs cycle. With the administration of an oral dose of 900 mg/day we obtained a reduction of total cholesterol (275 +/- 72 vs. 231 +/- 54 mg/dl; p less than 0.001), very-low-density lipoprotein (VLDL)-cholesterol (66 +/- 36 vs. 46 +/- 18 mg/dl; p less than 0.01) and triglycerides (332 +/- 182 vs. 227 +/- 90 mg/dl; p less than 0.01) at 2 months. High-density lipoprotein (HDL)-cholesterol did not change, but the total cholesterol/HDL-cholesterol ratio decreased significantly (p less than 0.05). Total cholesterol, VLDL and triglycerides showed a progressive and significant reduction at 4 and 6 months. No changes were observed in serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, uric acid, blood glucose and glycosylated hemoglobin. Gastric discomfort in 2 patients and pruritus in another one were the secondary effects related. Pantethine was shown to be a very effective hypolipemic agent in diabetic patients on dialysis with a great tolerance.
Moiseenok AG, et al. The Protective Effect of Pantothenic Acid Derivatives and Changes in the System of Acetyl CoA Metabolism in Acute Ethanol Poisoning. Farmakol Toksikol. Oct1988;51(5):82-86.
Calcium pantothenate (CaP), calcium 4′-phosphopantothenate (CaPP), pantethine, panthenol, sulfopantetheine and CoA decrease acute toxicity of acetaldehyde in mice. All studied compounds diminish duration of the narcotic action of ethanol–ET (3.5 g/kg intraperitoneally) in mice and rats. In the latter this effect is realized at the expense of “long sleeping” and “middle sleeping” animals. CaP (150 mg/kg subcutaneously) and CaPP (100 mg/kg subcutaneously) prevent hypothermia and a decrease of oxygen consumption in rats induced by ET administration. Combined administration of ET, CaP and CaPP leads to a characteristic increase of acid-soluble CoA fractions in the rat liver and a relative decrease of acetyl CoA synthetase and N-acetyltransferase reactions. The antitoxic effect of preparations of pantothenic acid is not mediated by CoA-dependent reactions of detoxication, but most probably is due to intensification of ET oxidation and perhaps to its elimination from the organism.
Chernikevich IP, et al. Possible ways of regulating detoxifying processes in the alcohol dehydrogenase reaction with pantothenic acid derivatives. Vopr Med Khim. Mar1993;39(2):38-40.
Oxidation of derivatives and precursors of pantothenic acid was studied in alcohol dehydrogenase reactions. Despite the presence of free hydroxymethyl groups in a number of pantothenic acid derivatives only panthenol with Km = 8 x 10(-3) M was shown to serve as a substrate for alcohol dehydrogenase from horse liver tissue (EC 188.8.131.52) Pantethine, sodium phosphopantothenate, CoA and acetyl-CoA decreased the rate of ethanol oxidation, where pantethine and sodium phosphopantothenate were competitive inhibitors, while CoA and acetyl-CoA inhibited the enzyme noncompetitively Ki = 1.2 x 10(-2) M, 2.1 x 10(-2) M, 4.4 x 10(-4) M and 5.1 x 10(-4) M, respectively. Metabolic precursors, which were different from pantothenic acid in their structure, were not involved in the alcohol dehydrogenase reaction. Possible regulation of alcohol intoxication using derivatives and precursors of vitamin B3 is discussed.
Cooper Jl. P3-400: Biotin deficiency and abnormal pantothenic acid levels in dementia. Alzh Demt. Jul 2008;4(4):T638-T639.
Background: Biotin and pantothenic acid deficiences are thought to be rare conditions. Elevated levels of pantothenic acid, a water-soluble vitamin, have not been reported in the medical literature. These vitamins are essential for energy metabolism and acetylcholine production. More than 50 patients in our memory clinic have been identified with biotin deficiency. Half of these patients have elevated pantothenic acid levels and a third have a pantothenic acid deficiency. Changes in the globus pallidus interna (GPi) on magnetic resonance imaging (MRI) have been identified which appear to correlate with biotin deficiency and dementia. Methods: Serum levels of biotin and pantothenic acid were obtained on 54 patients being evaluated in a community-based memory clinic when they presented with a dementia and T2-weighted MRI images revealed hypointensity in the GPi with or without an area of central hyperintensity. Hippocampal atrophy was estimated by the author using coronal MRI images at the level of the mammillary bodies. Results: Abnormal serum biotin levels were identified in 96.3% of patients with dementia and hypointensity of the GPi on T2-weighted MRI; 50 patients (92.6%) had a biotin deficiency (<200 pg/ml) and 74% had biotin levels <100 pg/ml. Pantothenic acid levels were normal in ten patients (normal range 200-1800 ng/ml), elevated in 50% of patients (range 2081-28,597 ng/ml) and low in 31.5% of patients. Hippocampal atrophy was absent or mild in 45/54 cases (83%). An area of central hyperintensity within the GPi hypointensity is seen in 39/54 cases (72%).
Leung LH. Pantothenic Acid Deficiency as the Pathogenesis of Acne Vulgaris. Medical Hypothesis. Jun1995;44(6):490-92.
For years, the pathogenesis of acne vulgaris has been known to be strongly influenced by hormonal factors. However, the exact role of and the interrelationship among the various hormones in question have not been well elucidated. Here, I wish to suggest a radically different theory for its pathogenesis and relate its basic pathology to a deficiency in pantothenic acid, a vitamin hitherto not known to cause any deficiency syndrome in humans. Hence, the effect of hormonal factors in this disease entity becomes secondary to that of the availability of pantothenic acid. A complete cure of this condition is effected by a very liberal replacement therapy with the vitamin.
Tarasov I, et al. Adrenal Cortex Functional Activity in Pantothenate Deficiency and the Administration of the Vitamin or Its Derivatives. Vopr Pitan. Aug1985;(4):51-54.
Study of the corticosteroid content in the adrenals and blood of rats under pantothenate deficiency has demonstrated a decrease in adrenocortical function. A single administration of pantothenate in a dose of 3.3 mg/kg reduced the influence of hypovitaminosis on the adrenals. The pantothenate derivatives (pantethine, 4′- phosphopantothenate and CoA in particular) injected to intact animals in a single dose equimolar to 3.3 mg/kg calcium pantothenate per kg bw had a marked steroidogenous effect
Biederman J. Family-environmental risk factors for attention deficit hyperactivity disorder. Arch Gen Psychiatry. 1995;52:464-470.
BACKGROUND: This study investigated whether family-environment risk factors are associated with attention-deficit hyperactivity disorder (ADHD). Compelling work by Rutter and coworkers revealed that it was the aggregate of adversity factors (severe marital discord, low social class, large family size, paternal criminality, maternal mental disorder, and foster care placement) rather than the presence of any single factor that led to impaired development. Based on the work of Rutter, we hypothesized a positive association between indicators of adversity and the diagnosis of ADHD and ADHD-associated impairments.
METHODS: We studied 140 ADHD and 120 normal control probands. Subjects were non-Hispanic white boys between the ages of 6 and 17 years. Rutter’s indicators of adversity were used to predict ADHD-related psychopathology as well as impaired cognitive and psychosocial functioning.
RESULTS: The odds ratio for the diagnosis of ADHD increased as the number of Rutter’s adversity index predicted ADHD-related psychopathology (depression, anxiety, and conduct disorder), learning disabilities, cognitive impairment, and psychosocial dysfunction.
CONCLUSIONS: A positive association appears to exist between adversity indicators and the risk for ADHD as well as for its associated psychiatric, cognitive, and psychosocial impairments. These findings support the work of Rutter and stress the importance of adverse family-environment variables as risk factors for children with ADHD.
General Practitioner Research Group. Calcium Pantothenate in Arthritic Conditions. Practitioner. Feb1980;224(1340):208-11.
Guillard O, et al. Treatment of Constipation with Vitamin B5 or Dexpanthenol. Med Chir Dig. 1979;8(7):671-74.
Arsenio L, et al. Effectiveness of Long-term Treatment with pantethine in patients with Dyslipidemia. Clin Ther. 1986;8(5):537-45.
one-year clinical trial with pantethine was conducted in 24 patients with established dyslipidemia of Fredrickson’s types II A, II B, and IV, alone or associated with diabetes mellitus. The treatment was well tolerated by all patients with no subjective complaints or detectable side effects. Blood lipid assays repeated after 1, 3, 6, 9, and 12 months of treatment revealed consistent and statistically significant reductions of all atherogenic lipid fractions (total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B) with parallel increases of high-density lipoprotein cholesterol and apolipoprotein A. The results were equally good in patients with uncomplicated dyslipidemia and in those with associated diabetes mellitus. The authors conclude that pantethine (a drug entity related to the natural compound, pantetheine) represents a valid therapeutic support for patients with dyslipidemia not amenable to satisfactory correction of blood lipids by diet alone.
Scheurig AC. Association between the intake of vitamins and trace elements from supplements and C-reactive protein: results of the MONICA/KORA Augsburg study. Eur J Clin Nutr. 2008 Jan;62(1):127-37.
OBJECTIVE: To examine the association between plasma concentrations of C-reactive protein (CRP) and the intake of vitamins and trace elements from supplements possibly related to inflammation such as vitamin C, vitamin E, carotenoids, selenium and zinc.
DESIGN: Cross-sectional study using data from the Monitoring of Trends and Determinants in Cardiovascular Disease/Cooperative Health Research in the Region of Augsburg (MONICA/KORA) Survey 1994/95.
SETTING: Region of Augsburg, Southern Germany.
SUBJECTS: Population-based sample of 2045 women and 2172 men, aged 25-74 years.
RESULTS: Intake of dietary supplements containing vitamins and trace elements was associated with lower CRP levels in women. Especially vitamin E in combination with other vitamins like vitamin C, vitamin B(1), B(2), B(6), B(12), niacin, folic acid, pantothenic acid and selenium, was significantly associated with lower CRP levels. Odds ratios for elevated CRP levels (>3.0 mg/l) after multivariable adjustment were 0.57 (95% confidence interval (CI): 0.37, 0.89) for the intake of vitamin E and 0.57 (95% CI: 0.35, 0.91) for the intake of multivitamins, defined as taking three or more different vitamins. These associations were not seen in men. Intake of vitamin C, carotenoids or zinc was not significantly associated with levels of CRP in both men and women.
CONCLUSIONS: Our data indicate that the intake of certain vitamins and trace elements from supplements is associated with lower CRP concentrations in women. Thus, intake of these micronutrients could influence the inflammatory process underlying the pathogenesis of atherosclerosis. Specific dose response relationships and the best combinations of vitamins and trace elements have to be determined in further studies.
Lacroix B, et al. Role of Pantothenic and Ascorbic Acid in Wound Healing Processes: In Vitro Study on Fibroblasts. Int J Vitam Nutr Res. 1988;58(4):407-13.
In order to analyze the possible role of pantothenic acid (PA) and ascorbic acid (AA) in wound healing processes, the effects of these vitamins upon the growth of fibroblasts, obtained from human fetal skin or foreskin, were studied. Cell proliferation, protein synthesis and protein release were evaluated. The rate of cell growth remained identical when PA or AA were added to the culture medium. PA increased the basal incorporation of 14C proline into precipitated material while AA did not modify this action. However, when cultures were incubated with PA and AA, the release of intracellular protein into the culture medium increased. These results suggest that the combined use of these two vitamins might be of interest in postsurgical therapy and in wound healing.
Ellinger S. Efficacy of vitamin supplementation in situations with wound healing disorders: results from clinical intervention studies. Curr Opin Clin Nutr Metab Care. 2009 Nov;12(6):588-95.
PURPOSE OF REVIEW: This review evaluates the efficacy of vitamin supplementations for prevention and treatment of pressure ulcer and surgical wounds on the basis of recent clinical intervention studies.
RECENT FINDINGS: Intervention studies show that an energy and protein-rich oral nutritional supplement providing high doses of vitamin C and zinc in combination with arginine may prevent the development of pressure ulcers. This measure seems to improve the healing of pressure ulcer, which is questionable for vitamin C alone. For surgical wounds, data from randomized controlled studies are scarce, but results on the use of vitamin C in combination with pantothenic acid are promising.
SUMMARY: Considerable evidence suggests that supplementation of vitamin C together with zinc by an oral nutritional supplement rich in energy, protein and arginine may be an efficient tool for pressure ulcer healing in contrast to single vitamin C. The evidence for prevention of pressure ulcer by such an oral nutritional supplement is comparably low. This fits also for single vitamin C supplementation in the healing of surgical wounds. Further, well designed and well powered studies on the benefit of antioxidant vitamins for wound healing within a diet providing adequate energy and protein are necessary.
Raczynska K, Iwaszkiewicz-Bilikiewicz B, Stozkowska W, Sadlak-Nowicka J. Clinical evaluation of provitamin B5 drops and gel for postoperative treatment of corneal and conjuctival injuries. Klin Oczna. 2003;105(3-4):175-8.
PURPOSE: Vitamins B group are important ingredients of coenzymes. Provitamin B5 dexpanthenol is necessary in the processes of reconstruction of epithelium, has regenerative and anti-inflammatory properties. Objective of the study was to determine how the wounds of cornea and/or conjunctiva heal upon the application of D-panthenol/the medicine has been developed in the Faculty of Pharmacy of the Medical University of Gdansk/.
MATERIAL AND METHODS: The activity of the medicine was tested in 40 eyes in the test group, a 40 eyes in the control group did not receive D-panthenol. The degree of the objective and subjective symptoms was assessed.
RESULTS: The differences between the two groups commenced on the second day following the operation. Better effects were observed in patients receiving D-panthenol. Congestion and oedema of conjunctiva withdrew, the edges of wounds demonstrated smoothness and better adherence. Subjective feelings improved.
CONCLUSIONS: 1. Provitamin B5 contained in 5% drops and 5% gel of D-panthenol effectively accelerates the processes of healing the wounds of conjunctiva and cornea.
Dr. Roger Williams discovered vitamin B5 in 1933 and, since it is present in all cells studied, he named it pantothenic acid from the Greek word panthothen meaning “everywhere.” Pantothenic acid plays a number of essential metabolic roles including the production of some hormones and neurotransmitters, and is involved in the metabolism of all carbohydrates, fats, and proteins.
Chemically, pantothenic acid consists of a carboxylic acid group bound to beta-alanine, which is an isomer of the amino acid alanine. Vitamin B5 as calcium pantothenate is most commonly available commercially. After absorption, pantothenic acid is converted to a sulfur-containing compound called pantetheine. Pantetheine is then converted into co-enzyme A, which is the only known biologically active form of pantothenic acid.
Pantethine, which is the stable and most active form of pantetheine, has been reported to be effective at improving abnormal lipid profiles in both adults and children. It reportedly lowers elevated triglycerides and LDL cholesterol while raising levels of the beneficial HDL cholesterol. [ Ref. ] Pantethine has been reported to be especially effective at lowering elevated blood lipids in patients with diabetes without hindering blood sugar control. [ Ref. ] , [ Ref. ]
Calcium pantothenate; dexpanthenol, which is the alcohol of pantothenic acid; and pantethine, the stable disulfide form of pantetheine, which is the biologically active form of pantothenic acid and the direct precursor to Coenzyme A (CoA). Pantethine and pantothenic acid are not necessarily clinically interchangeable.
Most of the pantothenic acid that is ingested is in the form of coenzyme A. Coenzyme A is hydrolyzed by intestinal enzymes to pantetheine. If calcium pantothenate or pantothenic acid is ingested as nutritional supplements, they must first be converted to pantetheine by intestinal enzymes before being absorbed. Within cells throughout the body, pantetheine is synthesized into the various active coenzyme compounds.
Toxicities & Precautions
There are no known toxicities associated with pantothenic acid.
Ingestion of large amounts may cause diarrhea.
Functions In The Body
Synthesis of steroid hormones and proper functioning of the adrenal glands.
Co-enzyme A (CoA), which is the active form of pantothenic acid, helps transfer two-carbon units (acetyl groups) in a wide variety of biochemical reactions.
Enhances the release of energy from carbohydrates in the Krebs cycle.
Involved in synthesis of phospholipids, fats, cholesterol, and bile acids.
Involved in synthesis of acetylcholine. [ Ref. ]
Red Blood Cells
Involved in synthesis of porphyrin in the hemoglobin of red blood cells.
Pantothenic acid deficiency may be a primary cause of acne vulgaris. [ Ref. ]
Pantothenic acid is required for the synthesis of adrenal steroid hormones. [ Ref. ]
Some allergic individuals respond well to pantothenic acid therapy. [ Ref. ]
Rheumatoid arthritis patients with low B5 levels have more severe disease symptoms. [ Ref. ]
At therapeutic doses peristalsis is stimulated. [ Ref. ]
Elevated cholesterol and triglycerides are lowered by pantethine, but not pantothenic acid. [ Ref. ]
A recent study found that participants taking vitamin B5 in conjunction with vitamin E showed lower levels of C-reactive protein levels. [ Ref. ]
Surgery And Wound Healing
In combination, pantothenic acid and ascorbic acid significantly enhance postsurgical therapy and wound healing. [ Ref. ] , [ Ref. ] Another study found that vitamin B5 accelerated the healing process of conjunctiva and the cornea after reconstructive surgery of the epithelium. [ Ref. ]
Symptoms and Causes of Deficency
Pantothenic acid is so widely available in foods that a deficiency in humans is rare. Experimentally induced deficiencies manifest as problems related to the skin, liver, thymus, and nerves.
Pantothenic acid is present in all plant and animal tissues. The best sources of this vitamin include eggs, liver, fish, chicken, whole grain breads, and cereals, and legumes. Other good sources are cauliflower, broccoli, lean beef, white and sweet potatoes, and tomatoes.