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Theophylline attenuates circulating vitamin B6 levels in children with asthma
T Shimizu1, S Maeda, H Mochizuki
1Department of Pediatrics, Gunma University School of Medicine, Maebashi, Japan.
Insights
Theophylline treatment in children with asthma significantly lowers vitamin B6 levels, specifically pyridoxal 5'-phosphate (PLP). This study highlights a crucial interaction between asthma medication and vitamin B6 status in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Nutritional Biochemistry
- Pharmacology
Background:
- Asthma is a common chronic respiratory disease in children.
- Theophylline is a bronchodilator used in asthma management.
- Vitamin B6 (pyridoxine) is essential for numerous metabolic processes.
Purpose of the Study:
- To investigate the impact of theophylline on vitamin B6 levels in children with asthma.
- To determine if theophylline affects serum pyridoxal 5"-phosphate (PLP) and pyridoxal (PL) concentrations.
Main Methods:
- Study included 26 children with asthma, with 20 on slow-release theophylline and 6 controls.
- Measured steady-state serum theophylline, PLP, and PL levels.
- Assessed the effect of a single oral dose of theophylline on PLP and PL levels in a subset of patients.
Main Results:
- Asthmatic children treated with theophylline showed significantly lower serum PLP levels compared to controls.
- A significant negative correlation was found between serum theophylline and PLP levels.
- A single oral dose of theophylline depressed serum PLP levels within 4 hours.
Conclusions:
- Theophylline therapy induces a depression of circulating pyridoxal 5"-phosphate (PLP) levels in pediatric asthma patients.
- This finding suggests a potential need for monitoring vitamin B6 status in children receiving theophylline.
- Further research may explore the clinical implications of theophylline-induced PLP depletion.
Abstract:
This study was undertaken to investigate the effect of theophylline on circulating vitamin B6 levels in children with asthma. Twenty-six asthmatic children, including 20 patients who were treated with slow-release theophylline and 6 patients not receiving any type of theophylline preparation, were enrolled in this study. Steady state serum theophylline and vitamin B6 [pyridoxal 5'-phosphate (PLP) and pyridoxal (PL)] levels were evaluated in these patients. A depression of serum PLP levels existed in asthmatic children treated with theophylline compared to those not receiving theophylline (5.3 +/- 0.5 vs. 9.0 +/- 1.4 ng/ml, mean +/- SEM; p < 0.05). A significant negative correlation between the serum levels of PLP and theophylline was demonstrated in the subjects of this study (rs = -0.609, p < 0.001). Oral administration of 200 mg of theophylline (TheoDur) to 5 children with asthma significantly depressed serum PLP levels 4 h after the drug intake (p < 0.05), whereas theophylline did not affect serum PL levels. From these results, we conclude that theophylline induces a depression of circulating PLP levels in asthmatic children.