Vitamin A May Reduce Risk of Pancreatitis While Treating ALL – ScienceDaily

A diet rich in vitamin A or its analogs reduces the risk of children and young adults with acute lymphoblastic leukemia (ALL) developing painful pancreatic inflammation during chemotherapy treatment. is useful for

Details on this potential diet to prevent potentially life-threatening adverse events were published on March 15, 2023. Science Translational MedicineThe research team includes Sohail Husain, M.D., Ph.D., director of pediatric gastroenterology, hepatology, and nutrition at Stanford University, and Anil Goud Jegga, Ph.D., DVM, MRes, computational biologist at Cincinnati Children’s Hospital Medical Center. headed by

For patients with ALL, treatment with the enzyme asparaginase helps starve cancer cells by reducing the amount of asparagine circulating in the blood. The drug is given by intravenous, intramuscular, or subcutaneous injection.

However, an estimated 2% to 10% of asparaginase users develop pancreatic inflammation in response to asparaginase treatment. In his third of these people, symptoms can be severe.

Jegga et al. include gene expression data, small molecule data, and electronic health records to further understand the mechanisms that cause asparaginase-associated pancreatitis (AAP) and identify potential interventions to prevent or mitigate AAP. Developed predictive analytics using over 100 million data points.

First, we analyzed a large set of gene expression data to reveal that gene activity associated with asparaginase or pancreatitis can be reversed by retinoids (vitamin A and its analogues). The team found more supporting evidence by “mining” millions of electronic health records from the TriNetX database and the US Federal Drug Administration’s adverse event reporting system.

This numerical computation and predictive analytics work included the use of Software developed at Cincinnati Children’s by Mayur Sarangdhar, PhD, MRes, and colleagues. The research team also studied data from mouse experiments and compared plasma samples from her ALL patients who developed pancreatitis and those who did not.

Ultimately, the team established two sets of human “real world” experiences. They found that only 1.4% of patients treated with asparaginase developed pancreatitis when they were taking vitamin A, compared with 3.4% of those who did not take vitamin A. Concomitant vitamin A was associated with a 60% reduction in the risk of AAP. The lower the amount of vitamin A in the diet, the higher the risk and severity of AAP.

“This study demonstrates the potential of mining ‘real-world’ data to identify treatment modifiers to improve patient outcomes. If the primary drug induces toxicity but is important for therapy such as asparaginase, therapeutic modifiers such as vitamin A and its analogues may be of direct relevance to patients with asparaginase and those ‘at risk’ for AAP. There is,” said Sarangdhar, co-lead author of the study.

Mr Jegga said: Prevent or reduce this side effect. ”

next step

In some respects, the lessons learned from this study may be immediately applicable to patient care. However, more clinical studies are needed to establish the amount of vitamin A required to protect all patients from pancreatitis. Whether the level of protection can be achieved through diet or supplementation. In fact, target vitamin levels may need to be altered depending on individual differences in metabolism.

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