ART OF CYTOLOGY
by Suzanne L. Adams, CT (ASCP),
Cytologist and Artist

Dedicated to Education & Research in Nutrition & Disease Prevention
Helping to Build Strong Genes and Healthy Cells

Play Your Part in the Prevention of Birth Defects and Disease Processes-
Take a Quality Assured Multivitamin/Mineral High in Folic Acid Every Day
 

.FOLIC ACID/B12 DEFICIENCY

Important New Reports
Experts Urge Wider Folic Acid Use
Scotland Rates of Spina Bifida Rise
Folic Acid Enzymes Inhibit UV Sun Damage
Selenium and Folate Reduce the Risk of Colon Cancer
Autism and Cerebral Folate Deficiency
Autism, An Extreme Challenge in Integrative Medicine
B6, Magnesium, Folic Acid, Zinc are Beneficial in Many Autism Cases
Folate Status in Pregnancy , C677T Gene Mutation, and Autism
B12 Deficiency and NTD Birth Defects
March of Dimes on Folic Acid
Maternal Folic Acid Counteracts BPA-Induced DNA Damage
Folic Acid Blood Levels Keep Falling In Young Women, Despite Fortification of Grains
MMWR-2007-Full Report
Most Likely Reason: Decreased Consumption of Grains Due to Low Carb and Gluten-Free
Diets, and the Increase Use of Hormones and Prescription Drugs Known to Deplete Folic Acid.

Drugs, Folic Acid,  and Birth Defects
Drugs that Deplete Folic Acid
Drugs that Deplete B12
Paxil and Birth Defects
Folic Acid and NTD Related Birth Defects Update-2009

See Also Suzanne's Nutrition Site

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Cytopathology Illustrations
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Folic Acid Deficiency Changes in Cervical Cells

(illustration by Suzanne L. Adams, CT(ASCP), copyright)
May be called "Atypical Cells of Undetermined Significance"
or "Benign Cellular Changes" on a Pap Report


(illustration by Suzanne L. Adams, CT(ASCP), copyright)
Radiation/Chemotherapy Effect in Cervical Cells

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GENERAL INFORMATION
    Although macrocytic formation of hematopoetic cells has commonly been the first recognized disorder of a folic acid/B12 deficiency, changes in the hormone sensitive, rapidly proliferating cells of the cervix often develop several weeks sooner (DeMay RM, 1996,Koss LG 1979,  Klaus H, 1971).  Cell changes of overall cytomegaly (enlargement of both cytoplasm and nucleus while maintaining a normal N/C ratio) as well as nuclear folding and creasing are characteristic (Van Niekerk WA, 1966, Klaus H, 1971).  Changes can be deceptively similar to dysplasia, especially if associated with chronic hormone use (see illustration, hormone effect), and new studies show a deficiency in cervical cells may be the precursor stage of HPV (human papilloma virus) (Kwasniewska A, 1997, Koss LG, 1979). High levels of folic acid appear to provide a protective effect against the initiation of HPV-related dysplasias (Piyathilake CJ,2004, Liu T, 1995, Harper JM, 1994, Grio R, 1993, Butterworth CE, 1993).  Improving folate acid levels in women at risk of getting infected or who are already infected with high-risk HPV may have a positive impact in the prevention of cervical cancer (Piyathilake CJ, 2004). Alterations in other types of epithelial cells such as gastric, bronchial, and endothelial, are known to occur as well (Heimburger DC, 1992).  Radiation and chemotherapy effect cells similarly as these interventions arrest cell division by inhibiting DNA thymine synthesis of which folic acid takes part (Ames BN, 1999, DeMay RM, 1996). Antioxidant deficiencies (vitamins A, E, C, zinc, and selenium) have been shown to exhibit the same morphological cell changes as folic acid/B12 deficiency (Ames BN, 1999,  Blount BC, 1997; see also, Hormone Effect).

CHARACTERISTIC CERVICAL CELL CHANGES

SQUAMOUS CELLS
 *General cytomegaly most often occurring in intermediate cells
*Cells may enlarge to 70 microns in diameter or more
*Superficial cells may be effected similarly but not as often
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NUCLEAR CHARACTERISTICS
 *Nuclei >14 microns in diameter, about twice their normal size
*Nuclear membrane folding and creasing may be more frequent than cytomegaly
*Look for longitudinal lines of chromatin within the nucleus
*Enlarged nuclei usually appear bland with prominent chromocenters
*Nuclear clearing (wide pale clear space around the nucleus) may be seen,
especially in association with radiation and chemotherapy
*Occasional "masquerading" dysplastic nucleus may be found
*Sometimes overall changes may mimic mild dysplasia
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CYTOPLASMIC FEATURES
*Enlarged, pale, and often polychromatic
*Vacuolization may be quite pronounced, especially around the nucleus
*Conspicuous fibrils (thin lines that ring the nucleus) may be observed
*Bizarre shapes may be found, some with psuedopod-like projections
(they are more frequently associated with radiation and chemotherapy)
*PMN’s may be ingested in vacuoles

METAPLASTIC CELLS
*May appear enlarged with bland nuclei
*Some groups may look reactive but remain intact

ENDOCERVICAL GLAND CELLS
*May be enlarged with hypochromatic nuclei
 *Some groups may acquire a reparative expression
*Vacuolization and enlargement of cytoplasm can be seen
*Some crowding and hyperchromasia may be worrisome

ASSOCIATED CELLS/CHANGES
*Occasional bizarre enlarged bi or multinucleated macrocytes
(bizarre cells are more often associated with radiation and chemotherapy)
*Hypersegmented PMN’s are possible (5-6 or more lobes)
*Inflammation may or may not be present

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More Important Folic Acid/B12 Research

Cervical and Breast Cancer
Folic Acid is Protective Against Breast Cancer
Diet and Premalignant Lesions of the Cervix:
Protective Role of Folate, Riboflavin, Thiamin, and Vitamin B12
Folate Deficiency and HPV Infection
Folic Acid Deficiency and HPV
Folate Deficiency is Associated with the Natural Progression of HPV Infection
Oral Contraceptive Use and Abnormal Cervical Cytology
 

Brain and Nervous System Function
Treatment of Alcoholic Polyneuropathy with Vitamin B Complex
Folic Acid Protects Motor Neurons Against ALS
The Worldwide Challenge of the Dementias: a Role for B Vitamins and Homocysteine
Alzheimer's Disease and Folic Acid
.Folic Acid, DNA, and Alzheimer's Disease
Homocysteine and B Vitamins Relate to Brain Volume and White-Matter
Changes in Geriatric Patients with Psychiatric Disorders
Folate and Cognitive Function
B Vitamin Deficiency in Neurological and Psychiatric Disorders
..Treatment of Depression: Time to Consider Folic Acid and B12
Role of Folic Acid in Neurological and Psychiatric Diseases
Folate and Depression

Birth Defects
Cerebral Folate Deficiency
Report of the Effects on Children with Brain Deficiency
 Autism and Cerebral Folate Deficiency
Endothelial Function in Newborn Infants is Related to Folate Levels and Birth Weight
Folic Acid Deficiency and Birth Defects
It's Not Just about NTD's
Folic Acid Blood Levels Falling In Young Women, Even After Fortification
MMWR-2007-Full Report
B12 Deficiency and NTD Birth Defects
Can You Pass the Folic Acid Quiz?
"Point 4 the Future" Campaign
A Folic Acid Awareness Program Aimed at Increasing Folic Acid
Intake Among College WomenTo Protect Future Generations

Heart Disease and Stroke
Stroke Rates Take Major Dive After Folate Fortification of Grain
Effect of Folic Acid on Endothelial Function Following Acute Myocardial Infarction
Efficacy of Folic Acid Supplementation in Stroke Prevention
.Niacin (Vitamin B3) Improves HDL Levels
Plasma Folate, Vitamin B6, vitamin B12, Homocysteine, and Risk of Breast Cancer
 

Other
Age-Associated Changes in the Metabolism of Vitamin B(12) and Folic Acid
 

Excerpt from The Art of Cytology
Transcrition Factors and Micronutrients

Drugs that Deplete Folic Acid
Drugs that Deplete B12
 


 

Learn More About Nutrition and Cellular Health

The Art of Cytology:
An Illustrative Study Guide With Micronutrient Discussions

Book Reviews
 


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*On the web promoting optimal cellular nutrition since 1998*