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	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Material Perspective by Erbe, R. W. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

Nitrous oxide irreversibly oxidizes the cobalt atom of vitamin B₁₂, thereby inhibiting the activity of the cobalamin-dependent enzyme methionine synthase (or 5-methyltetrahydrofolate–homocysteine S-methyltransferase; Enzyme Commission code EC 2.1.1.13). Methionine synthase catalyzes the remethylation of 5-methyltetrahydrofolate and homocysteine to tetrahydrofolate and methionine (Figure 1). Methionine, by way of its activated form, S-adenosylmethionine, is the principal substrate for methylation in many biochemical reactions, including assembly of the myelin sheath, methyl substitutions in neurotransmitters, and DNA synthesis in rapidly proliferating tissues.¹

View larger version (13K): [in this window] [in a new window]   Figure 1. The Folate and Homocysteine Metabolic Cycles and the Enzymatic Site of Nitrous Oxide Toxicity. Co denotes cobalt.

 
We report . . . [Full Text of this Article]

Case Report

Methods

Fibroblast Culture and MTHFR Activity

Preparation and Sequence Analysis of Genomic DNA

RNA Analysis

Results

Enzyme Activity in Fibroblasts

Genomic DNA-Sequence Analysis

RNA Analysis

Discussion

Source Information

From the Departments of Anesthesiology (R.R.S., K.H.) and Medical Genetics (R.L.), University of Wisconsin Medical School, Madison; and the Departments of Human Genetics, Medicine, Pediatrics, and Biology, McGill University, Montreal (D.S.R.).

Address reprint requests to Dr. Hogan at the Department of Anesthesiology, B6/319 Clinical Sciences Center, 600 Highland Ave., Madison, WI 53792, or at khogan@facstaff.wisc.edu.

Related Letters:

Nitrous Oxide and 5,10-Methylenetetrahydrofolate Reductase
Burman J. F., Kaufman J. L., Hogan K., Erbe R. W.
Extract | Full Text | PDF  
N Engl J Med 2003; 349:1479-1480, Oct 9, 2003. Correspondence

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