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Background: B vitamin deficiency has been previously reported to be prevalent in patients with heart failure. However, clinical trials investigating the potential of B vitamin supplementation have failed to show benefit and have suggested some evidence of harm. Negative findings have been hypothesized to be the result of an anti-angiogenic effect associated with B vitamin supplementation. Objective: The current study aimed to determine the impact of vitamin B6 supplementation alone or in combination with folate and B12 on the angiogenic response in a rodent model of hind limb ischemia. Methods: Rats were divided randomly into three groups and fed one of three diets: control diet (CON), high B6 diet (HB6) or high B6+folate+B12 diet (TV). Following five weeks of diet therapy, ischemia was surgically induced in the hind limb. Changes in perfusion and markers of the angiogenic response were studied at either 5 (early) or 10 (late) weeks. Result: Circulating EPCs were reduced in HB6 animals, a finding that reached significance for the TV animals. Quantitative polymerase chain reaction analysis revealed a decline in VEGF and eNOS expression in HB6 and TV groups at week 10. Contrast enhanced ultrasound of the hind limb revealed a significant reduction in perfusion in HB6 and TV animals in comparison to CON at 10 weeks. B vitamin supplementation had no impact on EPC apoptosis or differentiation. Conclusion: Taken together, these results support a negative impact of B vitamin supplementation on the recovery of perfusion following ischemic injury which may be the result of a down-regulation of chemotactic gene expression, leading to lowered EPC recruitment from the bone marrow to the site of ischemic injury. Correspondence to: Mary Keith, Niagara North Family Health Team, 145 Carlton Street Unit #7, St. Catharines, Ontario, Canada; E-mail: mkeith@ niagaranorthfht.ca

Impaired recovery of hind limb muscle perfusion following ischemic injury in rodents receiving B vitamin supplementation