Brazilian Journal of Medical and Biological Research

Print ISSN 0100-879X
doi: 10.1590/S0100-879X2004000900003

Braz J Med Biol Res, September 2004, Volume 37(9) 1299-1302 (Short Communication)

Response to the Comments of H.B. Ferraz et al. about the paper "High doses of riboflavin and the elimination of dietary red meat promote the recovery of some motor functions in Parkinson's disease patients. C.G. Coimbra and V.B.C. Junqueira. Brazilian Journal of Medical and Biological Research, 36: 1409-1417, 2003" (to see Coimbra full paper click here)


(to see H.B. Ferraz et al. comments click here)

C.G. Coimbra1,2 and V.B.C. Junqueira3,4

1Setor de Neurologia, Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP, Brasil
2Departamento de Neurologia e Neurocirurgia, and 3Disciplina de Geriatria, Departamento de Medicina, Centro de Estudos do Envelhecimento, Universidade Federal de São Paulo, São Paulo, SP, Brasil
4VITÆ - Cromatografia Líquida em Análises Clínicas S/C Ltda., São Paulo, SP, Brasil
http://www.scielo.br/scielo.php?scri...rm=iso&tlng=en

Response to the comments
References
Correspondence and Footnotes

Key words: Parkinson's disease, Riboflavin, FAD, Glutathione, Iron, Hemin

We have reported a steady and progressive improvement of motor capacity in 19 sporadic Parkinson's disease (PD) patients treated with high doses (30 mg orally every 8 h) of riboflavin plus elimination of dietary red meat for 6 months (1). The treatment was based on the following preliminary observations: I) 31 of 31 consecutively evaluated PD patients were found to have an altered enzyme glutathione reductase activation coefficient (EGR-AC) and low plasma levels of flavin adenine dinucleotide (FAD) compared to the internationally determined normal range of FAD (125-300) and to local non-PD patients suffering from other neurodegenerative conditions (dementia without a clinical history or computed tomography scan images compatible with stroke), and II) 19 PD patients were found to consume large quantities of red meat (2,044 ± 1,439 g/week) compared with 19 sex-matched controls of similar age from the same social environment (789 ± 509 g/week). Since all PD patients had a normal dietary content of riboflavin, we proposed that I) PD patients may be a subset of the large group of individuals (10-15% of the general population) expressing flavokinase (FK) with low substrate affinity (poor absorbers of vitamin B2; Ref. 2), and II) a high dietary red meat consumption might trigger PD in predisposed individuals (expressing altered FK). A review of the metabolic pathways requiring the participation of both vitamin B2 active forms (flavin mononucleotide and FAD) indicated that the association of low riboflavin absorption and high dietary red meat consumption (high dietary hemin production) might account for most (if not all) neurochemical changes reported in PD including glutathione depletion, impaired mitochondrial complex I activity, mtDNA mutations, disturbed iron metabolism, and 6(OH)dopamine formation (1).

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