Received: 8 October 2018 Accepted: 12 December 2018 DOI: 10.1002/jimd.12060 REVIEW Disorders affecting vitamin B6 metabolism Matthew P. Wilson1 | Barbara Plecko2 | Philippa B. Mills1 | Peter T. Clayton1 1Genetics and Genomic Medicine, UCL GOS Institute of Child Health, London, UK Abstract 0 2Department of Pediatrics and Adolescent Vitamin B6 is present in our diet in many forms, however, only pyridoxal 5 -phosphate Medicine, Division of General Pediatrics, (PLP) can function as a cofactor for enzymes. The intestine absorbs nonphosphorylated University Childrens' Hospital Graz, B vitamers, which are converted by specific enzymes to the active PLP form. The role Medical University Graz, Graz, Austria 6 of PLP is enabled by its reactive aldehyde group. Pathways reliant on PLP include Correspondence amino acid and neurotransmitter metabolism, folate and 1-carbon metabolism, protein Philippa B. Mills, Genetics and Genomic and polyamine synthesis, carbohydrate and lipid metabolism, mitochondrial function Medicine, UCL GOS Institute of Child Health, 30 Guilford Street, London WC1N and erythropoiesis. Besides the role of PLP as a cofactor B6 vitamers also play other 1EH, UK. cellular roles, for example, as antioxidants, modifying expression and action of steroid Email:
[email protected] Communicating Editor: Slyvia Stockler- hormone receptors, affecting immune function, as chaperones and as an antagonist of Ipsiroglu Adenosine-5'-triphosphate (ATP) at P2 purinoceptors. Because of the vital role of PLP in neurotransmitter metabolism, particularly synthesis of the inhibitory transmitter Funding information γ Schweizerischer Nationalfonds zur -aminobutyric acid, it is not surprising that various inborn errors leading to PLP defi- Förderung der wissenschaftlichen Forschung ciency manifest as B6-responsive epilepsy, usually of early onset.