A diet high in vitamin A or its analogues may help adolescents and young adults with acute lymphoblastic leukemia (ALL) reduce their risk of painful pancreatic inflammation during chemotherapy, according to a study. Details about this potential dietary solution to prevent a potentially life-threatening adverse event were published in Science Translational Medicine on March 15, 2023. The research team was led by Sohail Hussain, MD, chief of pediatric gastroenterology, hepatology and nutrition at Stanford University, and Anil Goud Jegga, DVM, MRes, a computational biologist at Cincinnati Children’s Hospital Medical Center.
For people with ALL, treatment with the enzyme asparagine helps starve cancer cells by reducing the amount of asparagine circulating in the blood, which cancer cells need but cannot make themselves. The drug, often used in combination with other chemotherapy, is given through injection into a vein, muscle, or under the skin.
However, an estimated 2% to 10% of asparagus users develop inflammation of the pancreas in response to asparagus treatment. Symptoms can be severe in up to a third of these people. Jegga and colleagues developed predictive analysis using more than 100 million data points incorporating gene expression data, small-molecule data and electronic health records to better understand the mechanisms driving asparagus-associated pancreatitis (AAP). and identify potential interventions to prevent or reduce AAP.
First, they analyzed massive amounts of gene expression data to reveal that gene activity associated with asparagine or pancreatitis could be reversed by retinoids (vitamin A and its analogs). The team found more supporting evidence by “mining” millions of electronic health records from the TriNetX database and the US Federal Drug Administration Adverse Events Reporting System. This number crunching and predictive analytics work involved the use of AERSMine software developed by Mayur Sarangdhar, PhD, MRes, and colleagues at Cincinnati Children’s. The research team also studied data from experiments with mice and compared plasma samples from everyone who developed pancreatitis and those who did not.
Ultimately, the team established two sets of human “real world” experiences. They found that only 1.4% of patients treated with asparagus developed pancreatitis when they were also taking vitamin A, as opposed to 3.4% of patients who were not. Vitamin A use correlated with a 60% reduction in the risk of AAP. Low intake of dietary vitamin A is related to increased risk and severity of AAP. Medicines, such as asparaginase, containing therapy modifiers, such as vitamin A and its analogs, may be of immediate relevance to patients on asparaginase and ‘at risk’ for AAP,” says Sarangdhar, co-first author of the study.
Also Read: 7 Effective Indian Home Remedies To Treat Cough And Cold
Jegga says: “Our study highlights the power of heterogeneous data integration and analysis in translational research. By leveraging existing `omics and patient-centred data and a systems approach, we identify new insights into the development of AAP and potential interventions.” were able to prevent or reduce this side effect. However, more clinical research is needed to establish what amount of vitamin A would be needed to protect all patients with pancreatitis; and whether dietary or A protective level can be achieved through supplementation. In fact, target vitamin levels may need to be varied according to individual differences in metabolism.