OUR KNOWLEDGE of chemical reactions involved in the intermediary metabolic pathways of the erythrocyte has grown considerably over the last three decades. It has been learned that the erythrocyte is an actively metabolizing cell, of use not only to evaluate nutritional anemia but also to demonstrate specific biochemical and metabolic defects in sickle cell anemia, congenital spherocytosis, drug induced hemolytic anemia, congenital galactosemia, and other disorders.1
Early studies showed that thiamine is an essential cofactor for the oxidation of alphaketo acids such as pyruvic and alphaketoglutaric acids.2 The oxidation of pyruvic acid is essential for the metabolism of carbohydrates, and the oxidation of alphaketoglutaric acid is a step in the Kreb's Cycle—the final common oxidative pathway for carbohydrate, protein, and fat. More recently it was shown that thiamine was associated with the enzyme transketolase, which functions in the utilization of pentoses, or 5-carbon sugars.3 Moreover, the erythrocyte is rich in the transketolase enzyme.4
Brin M. Erythrocyte as a Biopsy Tissue for Functional Evaluation of Thiamine Adequacy. JAMA. 1964;187(10):762–766. doi:10.1001/jama.1964.03060230090022
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