Question 1

What is the Meaning of Niacin Flush?

Accepted Answer

Niacin Flush is a common, transient, and non-harmful physiological reaction characterized by rapid cutaneous vasodilation, leading to redness, warmth, and often an intense itching or tingling sensation of the skin. This reaction typically occurs shortly after the ingestion of pharmacologic doses of nicotinic acid, which is a form of Niacin or Vitamin B3. This phenomenon is a prostaglandin-mediated response and is distinctly separate from a true allergic reaction.

Question 2

What is the Origin of Niacin Flush?

Accepted Answer

The term combines "Niacin," the common name for nicotinic acid, with "Flush," a descriptive term for the rapid onset of skin redness and warmth. The observation of this predictable side effect is as old as the therapeutic use of high-dose Niacin for the clinical management of dyslipidemia, or abnormal cholesterol levels. Understanding its specific biochemical basis is key to improving patient adherence to this effective lipid-modifying agent.

Question 3

What is the Mechanism of Niacin Flush?

Accepted Answer

The flush is primarily mediated by the activation of the G-protein coupled receptor, GPR109A, which is highly expressed on Langerhans cells and other immune cells in the skin. Niacin binds to this receptor, triggering the rapid synthesis and release of potent inflammatory mediators, specifically prostaglandin D2 (PGD2) and prostaglandin E2 (PGE2). These prostaglandins are powerful local vasodilators, causing the rapid dilation of cutaneous blood vessels, which manifests clinically as the sensation of warmth and visible redness.

Niacin Flush

Meaning

Origin

Mechanism

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