Changes in the activation of red blood cell transketolase of alcoholic patients during treatment

Erythrocyte transketolase activation by thiamin diphosphate has been studied in alcoholic patients on admission and after treatment, which included vitamin therapy. The high proportion of the patients who showed an abnormal activation of transketolase, not only by 0.3 mM thiamin diphosphate but also further activation by increasing the thiamin diphosphate to 3 mM, was reduced considerably after treatment. A few patients, however, still showed continuing abnormalities even after treatment. Further study of the enzyme activation in vitro confirmed the presence of an enzyme variant, abnormal both in the ease with which the thiamin diphosphate could be removed and in requiring a high concentration of thiamin diphosphate for activation. Since the modified transketolase activation test appears not only to monitor the effectiveness of thiamin therapy but also independently to warn of persisting enzyme abnormalities, it could prove to be of general use in alcohol detoxification units.