Pantethine
Encyclopedia
Pantethine is a dimeric form of pantothenic acid
Pantothenic acid
Pantothenic acid, also called pantothenate or vitamin B5 , is a water-soluble vitamin. For many animals, pantothenic acid is an essential nutrient. Animals require pantothenic acid to synthesize coenzyme-A , as well as to synthesize and metabolize proteins, carbohydrates, and fats.Pantothenic acid...

 (vitamin B5). It is composed of two molecules of pantothenic acid linked by cysteamine
Cysteamine
Cysteamine is the chemical compound with the formula HSCH2CH2NH2. It is the simplest stable aminothiol and a degradation product of the amino acid cysteine. It is often used as the hydrochloride salt, HSCH2CH2NH3Cl....

 bridging groups. The monomer of this compound is known as pantetheine
Pantetheine
Pantetheine is the cysteamine amide analogue of pantothenic acid . The dimer of this compound, pantethine is more commonly known, and is considered to be a more potent form of vitamin B5 than pantothenic acid. Pantetheine is an intermediate in the production of coenzyme A by the body....

 and is an intermediate in the production of Coenzyme A
Coenzyme A
Coenzyme A is a coenzyme, notable for its role in the synthesis and oxidation of fatty acids, and the oxidation of pyruvate in the citric acid cycle. All sequenced genomes encode enzymes that use coenzyme A as a substrate, and around 4% of cellular enzymes use it as a substrate...

 by the body. Pantethine is considered the more biologically active form of vitamin B5, but it is less stable, decomposing over time if it is not kept refrigerated. Most vitamin B5 supplements are therefore in the form of calcium pantothenate, a salt of pantothenic acid.

Dietary supplementation

Pantethine is available as a dietary supplement because of evidence of its health benefits. In multiple clinical trials of patients with elevated cholesterol and triglycerides, total and LDL cholesterol were decreased by 12%, triglycerides decreased by 18%, and HDL cholesterol was increased by 9%. These clinical trials were conducted with daily intakes ranging from 600 to 1200 mg/day. Within this dose range there is no evidence of a dose-effect relationship, i.e. changes in lipid concentrations overlapped across the range of doses. Direct dose-response evidence is not available because no trial tested more than one dose. A few trials tested 300 mg/day with more modest but still statistically significant results.

Physiological effects

Although pantethine can serve as a precursor for generation of vitamin B5, this is not thought to be the mechanism of action
Mechanism of action
In pharmacology, the term mechanism of action refers to the specific biochemical interaction through which a drug substance produces its pharmacological effect...

. Vitamin B5 requirements are on the order of 5 mg/day.

Two mechanisms of action are proposed for pantethine. In the first, pantethine serves as the precursor for synthesis of coenzyme A
Coenzyme A
Coenzyme A is a coenzyme, notable for its role in the synthesis and oxidation of fatty acids, and the oxidation of pyruvate in the citric acid cycle. All sequenced genomes encode enzymes that use coenzyme A as a substrate, and around 4% of cellular enzymes use it as a substrate...

. In the second, pantethine is converted to two pantetheine molecules which are in turn metabolized to form two pantethenic acid and two cysteamine molecules. Cysteamine is theorized to bind to and thus inactivate sulfur-containing amino acids in liver enzymes involved in the production of cholesterol and triglycerides.
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