Reticulocyte Response to Glutamic Acid in Pernicious Anemia

Abstract

The clinical trial of glutamic acid in cases of pernicious anemia as an antianemic substance was suggested by the following experimental observations. According to Abderhalden glutamic acid may be condensed into pyrrolidonecarboxylic acid. Hemin, the iron porphyrin, synthesized by Hans Fischer is composed of pyrrole rings. West, Howe and Dakin have recently isolated substances from liver tissue which are exceedingly active in pernicious anemia. These substances, identified by them as B-hydroxy-glutamic acid, -hydroxyproline, and as a tri-basic acid containing the pyrrolidone ring, are potential pyrrole percursors. More recently, Drabkin, and Miller found glutamic acid and certain other amino acids and compounds effective in the treatment of the anemia of rats caused by an exclusive milk diet. Those substances which produce remissions in the blood picture of pernicious anemia, known to contain potential pyrrole percursors, are probably liberated from certain protein foods by normal gastric digestion and then decomposed so that their products are available after absorption for the synthesis of hemoglobin and erythrocyte stroma. In pernicious anemia the necessary substances and their decomposition products are not made available to the organism in adequate amount due to some deficiency in the gastro-intestinal tract. Ajinomoto (Suzuki) used extensively in Japan as a condiment for giving a meat-like flavor to foods is an exceedingly economical form in which to administer sodium-glutamate. If sodium-glu-tamate were to prove effective in the treatment of pernicious anemia, Ajinomoto would be a relatively cheap therapeutic agent. Forty grams of Ajinomoto was therefore administered in boiling water in 4 equally divided doses daily to each of 4 patients suffering from pernicious anemia. In these doses the substance was well tolerated and in all instances promptly improved the appetite.