Pantothenic Acid

( Originally Published 1956 )

Demonstration that pantothenic acid is essential in animal nutrition and elucidation of its vital role in metabolic processes makes it practically certain that this vitamin is essential in man. Pantothenic acid is a constitutent of coenzyme A which occupies a central position in metabolism. This coenzyme is required for acetylation reactions. It functions in the synthesis and degradation of fatty acids and in the entry of fat and carbohydrate into the citric acid cycle. Coenzyme A functions in the synthesis of the porphyrin part of the hemoglobin molecule and in the formation of sterols and steriod hormones.

The wide distribution of pantothenic acid in foods may explain failure to observe deficiency even on severely restricted diets. Bean and associates (107) investigated the effects of a pantothenic acid-free diet, to which the pantothenic acid antagonist, omegamethyl pantothenic acid was added, in four human subjects. A number of physical and biochemical disturbances resulted, most of which appeared to be due to pantothenic acid deficiency. The subjects became quarrelsome, sullen, petulant and, at times, somnolent. Paraesthesias of the hands and feet were followed by the appearance of hyperactive reflexes, steppage gait and foot drop. Other findings were cardiovascular instability, especially in the upright position, gastrointestinal complaints and repeated infections. Biochemical changes included alterations in acetylation, carbohydrate metabolism, serum cholesterol concentration, plasma proteins, steroid hormone excretion, and failure of corticotropin ( ACTH) to induce eosinopenia. Plasma ascorbic acid concentration decreased while urinary excretion of thiamine and niacin rose during the period of pantothenic acid depletion. Individual variations in response to the regimen were large.

This study strongly suggests the essentiality of pantothenic acid in human nutrition. Bean and associates suggest, also, that "burning feet," a complaint of naturally occurring deficiency states, may be mediated by pantothenic acid deficiency. Gopalan has reported relief of the burning foot syndrome with pantothenic acid. In other studies, pantothenic acid has been reported to influence the reaction of human subjects to stress. Evaluation of pantothenic acid nutrition must await further investigation and the development and testing of procedures which will indicate metabolic defects due to deficiency of this vitamin.