Pellagra from niacin deficiency coupled with leucine excess

In the most general model of diseases/medical conditions:

toxins + deficiencies + excesses = {medical conditions}

where all four of the terms/variables are temporary and local

In at least one case, it appears that no toxin is necessary to create pellagra.

Niacin deficiency forces the body to use tryptophan to make niacin, and leucine excess inhibits one of the enzymes in the niacin synthetic pathway. Extreme niacin deficiency leads to pellagra. Many local pellagras make up the clinical condition of systemic pellagra.

However, the clinical course of any type of pellagra is surely going to be made worse by toxins that can exploit the deficiencies and excesses that underlie pellagra. In the ordinary course of the disease, toxins may consume either niacin or tryptophan or both.

 

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