Role of Calcium Pantothenate in Immunity

By-Nutrition Expert:Meena Ganagani,Practicing Clinical Nutritionist,Mumbai.

The Immune System

Multicellular animals have dedicated cells or tissues to deal with the threat of infection. Some of these responses happen immediately so that an infecting agent can be quickly contained. Other responses are slower but are more tailored to the infecting agent. Collectively, these protections are known as the immune system. The human immune system is essential for our survival in a world full of potentially dangerous microbes, and serious impairment of even one arm of this system can predispose to severe, even life-threatening, infections.(1)

Micro nutrients and the immune system

The task of the immune system is to protect the organism against harmful external influences, e.g., microorganisms. One consequence of an immune reaction is inflammation, which serves to remove foreign bodies or pathologically altered cells. However, if the immune reaction is not appropriate it may lead to undesirable effects, including increased vulnerability to infections if immune function is diminished, or allergies, autoimmune diseases and chronic inflammation in the case of hyper function. To fulfill its many and various protective and signaling functions, the immune system relies on the adequate availability of micro nutrients. Potential deficiencies can affect both unspecific (innate) and specific (acquired) immunity. (2)

Role of Calcium Pantothenate

Calcium Pantothenate is the calcium salt of the water-soluble vitamin B5, ubiquitously found in plants and animal tissues with antioxidant property. Pentothenate is a component of coenzyme A (CoA) and a part of the vitamin B2 complex. Vitamin B5 is a growth factor and is essential for various metabolic functions, including the metabolism of carbohydrates, proteins, and fatty acids. This vitamin is also involved in the synthesis of cholesterol, lipids, neurotransmitters, steroid hormones, and hemoglobin. (3)

The B vitamins have been shown to have an intestinal bacterial source and a food source, suggesting that the normal intestinal microbiome may have always been their primary source. B5 is ubiquitous in food and is supplied by the normal intestinal bacteria (Gominak, 2016). Foods rich in pantothenic acid include animal organs (liver and kidney), fish, shellfish, milk products, eggs, avocados, legumes, mushrooms, and sweet potatoes (Food and Nutrition Board et al., 1998). Pantothenic acid is also present at the active site of ACP, a component of the fatty acid synthesis complex. Absorbed pantothenic acid must first be released from CoA and ACP, steps that involve the actions of peptidases and nucleosidases (Strauss, 2010). As pantothenic acid is widely distributed in nature, its deficiency is extremely rare in humans. Its deficiency may cause a reduction in Łcortisol production, increased arthritic pain, myalgia, fatigue, headache, depression, insomnia, and widespread “pro-inflammatory” effects on the immune system. The deficiency also decreases the available acetylcholine, a neurotransmitter of the parasympathetic nervous system, manifesting by paresthesias and “Burning foot syndrome” (Gominak, 2016; Kennedy, 2016). It has a clear cholesterol‐lowering effect (Gaddi et al., 1984), and its ability to restore hair color needs further confirmation.

A substantial amount of Vitamin B5 is synthesized by the intestinal bacteria that normally colonize the human colon (“large intestine”). Probiotic bacteria, members of the gut microbiota, are able to synthesize panthotenic acid in humans (Hill, 1997). VB5 helps the body to build an effective immune response to resist infection (He et al., 2018).

The influence of Vitamin B5 on the immune system is exponentially growing and gaining fame. VB5 promotes immune cells to produce cytokines and is multifunctional. TNF‐α and IL‐6 were substantially increased in VB5‐treated bone marrow‐derived macrophages with no noticeable difference in the levels of IL‐4, IL‐10, and IL‐13, thus demonstrating a possible pro-inflammatory action (He et al., 2018). Based on the proposed antihistamine effect of B5 (Szórády, Horváth, &Tóth, 1966), it may play a role as a mast cell stabilizer and help in treatment of mast cell activation syndrome, which results from massive and inappropriate release of their content (Frieri, Patel, & Celestin, 2013). Due to the key involvement of VB5 in the synthesis of CoA, a critical cofactor in biochemical reactions in different organisms (Eldridge, 2004), it plays a chief role in inflammation (Jung et al., 2017) and could adjust the innate immune response via adjusting the CoA level. Oral administration of VB5 controlled the number of macrophages and enhanced CD4+ T cells to express interferon‐γ and IL‐17; thus, it effectively plays a role in the regulation of the innate and adaptive immunity (He et al., 2018). Differentiation of macrophages reflects and guides polarization of T cells in vivo (Muraille, Leo, & Moser, 2014; Wang, Liang, & Zen, 2014), whereas in vitro, it promotes the maturity of macrophages. As a paradoxical effect on cytokines, VB5 endorses neutrophils to produce anti‐inflammatory cytokines to slow down the recruitment or activation of macrophages in early infection but stimulates the secretion of pro-inflammatory cytokines to enhance their recruitment or activation in late infection (He et al., 2018). VB5 promoted the maturity of macrophages and phagocytosis and strengthened their potential activation status (He et al., 2018). (4)

Available Forms

Vitamin B5 can be found in multivitamins and B complex vitamins, or sold separately under the names pantothenic acid and calcium pantothenate. It is available in a variety of forms including tablets, softgels, and capsules.(5)

Nutrient Requirements and Recommended Dietary Allowances for Indians (ICMR 2010)

  • “Pantothenic acid (mg/d) is 5 mg”

References

  1. https://www.historyofvaccines.org/content/articles/human-immune-system-and-infectious-disease
  2. https://www.nutri-facts.org/en_US/news/micronutrients-and-the-immune-system.html
  3. https://pubchem.ncbi.nlm.nih.gov/compound/Calcium-D-pantothenate
  4. https://sci-hub.tw/https://doi.org/10.1002/ptr.6537
  5. https://www.mountsinai.org/health-library/supplement/vitamin-b5-pantothenic-acid

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