Abstract
Homocysteine is a thiol aminoacid synthesized during the metabolism of methionine. Increased plasma levels of homocysteine can be the result of mutations in the enzymes responsible for homocysteine metabolism, particularly cystathionine-β synthase (CBS) and 5,10-methylenetetrahydrofolate reductase (MTHFR). Additionally, nutritional deficiencies in B vitamin cofactors required for homocysteine metabolism, including folic acid, vitamin B6 (pyridoxal phosphate), and/or vitamin B12 (methylcobalamin), can induce hyperhomocysteinemia. Over the last decade, following in vitro and in vivo observations of a homocysteine-associated vascular pathology, convincing epidemiological evidence has been gathered on the relation between moderate elevation of plasma homocysteine and vascular disease, including cerebral ischemia. However, causality has yet to be established. The association between homocysteine and ischemic stroke might be a spurious epidemiological finding because of confounding or it might reflect reverse causality. If this is the case, elevated levels of plasma homocysteine should be interpreted as an epiphenomenon secondary to the vascular disease itself. Thus, whether lowering homocysteine concentration prevents cerebral ischemia remains to be determined. The only method to answer the question of the causal relation between homocysteine and ischemic stroke is by intervention trials in which patients at high vascular risk, such as those who have had a recent cerebral ischemic event are randomly allocated to placebo or homocysteine-lowering multivitamin therapy, and followed prospectively. Some of these randomized controlled trials are currently ongoing. Their results should hopefully resolve the issue in the next future.
Keywords: Homocysteine, mild hyperhomocysteinemia, stroke, Ischemic - 5, 10-methylenetetrahydrofolate reductase, (MTHFR), cystathionine-β Synthase (CBS), homocystinuria
Current Medicinal Chemistry
Title: Homocysteine and Cerebral Ischemia: Pathogenic and Therapeutical Implications
Volume: 14 Issue: 3
Author(s): Alessandro Pezzini, Elisabetta Del Zotto and Alessandro Padovani
Affiliation:
Keywords: Homocysteine, mild hyperhomocysteinemia, stroke, Ischemic - 5, 10-methylenetetrahydrofolate reductase, (MTHFR), cystathionine-β Synthase (CBS), homocystinuria
Abstract: Homocysteine is a thiol aminoacid synthesized during the metabolism of methionine. Increased plasma levels of homocysteine can be the result of mutations in the enzymes responsible for homocysteine metabolism, particularly cystathionine-β synthase (CBS) and 5,10-methylenetetrahydrofolate reductase (MTHFR). Additionally, nutritional deficiencies in B vitamin cofactors required for homocysteine metabolism, including folic acid, vitamin B6 (pyridoxal phosphate), and/or vitamin B12 (methylcobalamin), can induce hyperhomocysteinemia. Over the last decade, following in vitro and in vivo observations of a homocysteine-associated vascular pathology, convincing epidemiological evidence has been gathered on the relation between moderate elevation of plasma homocysteine and vascular disease, including cerebral ischemia. However, causality has yet to be established. The association between homocysteine and ischemic stroke might be a spurious epidemiological finding because of confounding or it might reflect reverse causality. If this is the case, elevated levels of plasma homocysteine should be interpreted as an epiphenomenon secondary to the vascular disease itself. Thus, whether lowering homocysteine concentration prevents cerebral ischemia remains to be determined. The only method to answer the question of the causal relation between homocysteine and ischemic stroke is by intervention trials in which patients at high vascular risk, such as those who have had a recent cerebral ischemic event are randomly allocated to placebo or homocysteine-lowering multivitamin therapy, and followed prospectively. Some of these randomized controlled trials are currently ongoing. Their results should hopefully resolve the issue in the next future.
Export Options
About this article
Cite this article as:
Pezzini Alessandro, Del Zotto Elisabetta and Padovani Alessandro, Homocysteine and Cerebral Ischemia: Pathogenic and Therapeutical Implications, Current Medicinal Chemistry 2007; 14 (3) . https://dx.doi.org/10.2174/092986707779941140
DOI https://dx.doi.org/10.2174/092986707779941140 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
Call for Papers in Thematic Issues
Advances in Medicinal Chemistry: From Cancer to Chronic Diseases.
The broad spectrum of the issue will provide a comprehensive overview of emerging trends, novel therapeutic interventions, and translational insights that impact modern medicine. The primary focus will be diseases of global concern, including cancer, chronic pain, metabolic disorders, and autoimmune conditions, providing a broad overview of the advancements in ...read more
Approaches to the treatment of chronic inflammation
Chronic inflammation is a hallmark of numerous diseases, significantly impacting global health. Although chronic inflammation is a hot topic, not much has been written about approaches to its treatment. This thematic issue aims to showcase the latest advancements in chronic inflammation treatment and foster discussion on future directions in this ...read more
Cellular and Molecular Mechanisms of Non-Infectious Inflammatory Diseases: Focus on Clinical Implications
The Special Issue covers the results of the studies on cellular and molecular mechanisms of non-infectious inflammatory diseases, in particular, autoimmune rheumatic diseases, atherosclerotic cardiovascular disease and other age-related disorders such as type II diabetes, cancer, neurodegenerative disorders, etc. Review and research articles as well as methodology papers that summarize ...read more
Chalcogen-modified nucleic acid analogues
Chalcogen-modified nucleosides, nucleotides and oligonucleotides have been of great interest to scientific research for many years. The replacement of oxygen in the nucleobase, sugar or phosphate backbone by chalcogen atoms (sulfur, selenium, tellurium) gives these biomolecules unique properties resulting from their altered physical and chemical properties. The continuing interest in ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Nano-constructed Carriers Loaded With Antioxidant: Boon For Cardiovascular System
Current Pharmaceutical Design BELFAST Centenarians: A Case of Optimal Cardiovascular Risk?
Current Pharmaceutical Design Treatments for Hypertension in Type 2 Diabetes-Non-pharmacological and Pharmacological Measurements<sup>#</sup>
Current Hypertension Reviews Status of Herbal Medicines in the Treatment of Diabetes: A Review
Current Diabetes Reviews Adiponectin: A Key Player in Obesity Related Disorders
Current Pharmaceutical Design Antiplatelet Therapy in Acute Coronary Syndromes. Evidence Based Medicine
Current Pharmaceutical Design Cardiovascular Biology of Interleukin-6
Current Pharmaceutical Design Endothelin-1 Actions on Vascular Smooth Muscle Cell Functions As a Target for the Prevention of Atherosclerosis
Current Vascular Pharmacology Ophthalmological and Otological Manifestations in the Antiphospholipid Syndrome
Current Rheumatology Reviews The Role of the Gut Microbiota in Energy Metabolism and Metabolic Disease
Current Pharmaceutical Design Neutrophil Cell Count is Related to Hypertension in Workers: A Cross- Sectional Study
Vascular Disease Prevention (Discontinued) Macrovascular Complications of Type 2 Diabetes Mellitus
Current Vascular Pharmacology Editorial [ Hot Topic:Stroke Bugs: Current and Emerging Concepts Relevant to Infection in Cerebrovascular Disease (Guest Editors: Hedley CA Emsley and Angel Chamorro)]
Infectious Disorders - Drug Targets Protein kinases and the Hypoxia-Inducible Factor-1, two switches in angiogenesis
Current Pharmaceutical Design Omentin: Linking Metabolic Syndrome and Cardiovascular Disease
Current Vascular Pharmacology Modified Polysaccharides as Versatile Materials in Controlled Delivery of Antidegenerative Agents
Current Pharmaceutical Design Gene-Nutrient Interaction in Type 2 Diabetes: An Appraisal of the Role of the Peroxisome Proliferator-Activated Receptor Pathway
Current Pharmacogenomics The Emerging Roles of Leptin and Ghrelin in Cardiovascular Physiology and Pathophysiology
Current Vascular Pharmacology Genetic Imbalance in Patients with Cervical Artery Dissection
Current Genomics Cardiac Multidetector Computed Tomography: Basic Physics of Image Acquisition and Clinical Applications
Current Cardiology Reviews