Pharmacists Can Suggest Increased Vitamin B12 Consumption to Prevent and Treat Acute Pancreatitis

Researchers assessed the role of vitamin B12 in the prevention and mitigation of acute pancreatitis (AP), to determine whether the vitamin displayed therapeutic effects in reducing the severity of the disease. The investigators combined human genetic epidemiology and animal models to confirm the role of B12.¹

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AP is a pancreatitis disease that relates to inflammation of the pancreas, specifically characterized by acinar cell necrosis and extensive local and systemic inflammation. It is one of the leading causes of hospital admission due to gastrointestinal diseases. Although the disease can impact individuals of all ages and usually presents as self-limiting mild AP, around 20% of individuals suffer from moderate or severe AP. According to study authors, once the disease is severe, the mortality rate is about 20% to 40%, with lifelong complications among those that recover.^1,2

In the early stages of AP development, the acinar cells are the first cell types to be injured, triggering a sterile proinflammatory response and resulting in systemic inflammatory response syndrome (SIRS) across the production of cytokines. If the SIRS is severe, the proinflammatory mediators can prompt multiple-organ failure. However, previous evidence show that high-dose parenteral vitamin B12 could modulate inflammatory responses in various organs, including SIRS among individuals that are critically ill.²

The research team, led by Chuanwen Fan, MD, in the Department of Gastrointestinal Surgery at West China Fourth Hospital, Sichuan University, and the Department of Biomedical and Clinical Sciences at Linköping University, conducted a meta-analyses of genome-wide association studies (GWAS) that used the largest genetic dataset available for pancreatitis.^1,2

The team employed a Mendelian randomized (MZ) analysis that used single nucleotide polymorphisms (SNPs) to investigate the relationship between multiple one-carbon metabolism nutrients and the risk of pancreatitis. The analysis found that higher vitamin B12 levels were related to a reduced risk of developing various types of pancreatitis.¹

The researchers then assessed whether vitamin B12 had therapeutic impacts on AP, using experimental models of pancreatitis in CD320 knockout mice. Out of 2 models used, one observed pancreatitis injury responses and the other tracked the pathological progression of AP, according to study authors.¹

The results displayed that artificially increasing serum vitamin B12 before and after the initiation of pancreatitis reduced the severity of the condition and added tissue repair following pancreatic injury. Additionally, the study authors noted that vitamin B12 enhanced ATP production in pancreatic tissue, reducing acinar cell necrosis and decreasing disease progression.¹

“These exciting new findings add to the growing evidence that vitamin B12 can reduce the severity of acute pancreatitis by increasing ATP levels in pancreatic tissue, offering novel insights into potential therapeutic strategies for this disease. This study lays a robust foundation for future clinical applications of vitamin B12 in managing acute pancreatitis,” said, Xianming Mo, senior author, West China Center of Excellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, Laboratory of Stem Cell Biology, State Key Laboratory, West China Hospital, Sichuan University, in a news release.¹

REFERENCES

1. Vitamin B12 Identified as a potential therapeutic agent in the prevention and treatment of acute pancreatitis. EurekAlert!. News release. October 17, 2024. Accessed October 17, 2024. https://www.eurekalert.org/news-releases/1061675.

2. Vitamin B12 protects necrosis of acinar cells in pancreatic tissues with acute pancreatitis. Wiley. News release. October 15, 2024. Accessed October 17, 2024. https://onlinelibrary.wiley.com/doi/10.1002/mco2.686.