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Moderate hyperhomocysteinemia and immune activation
K Schroecksnadel1, B Frick, B Wirleitner
1Institute of Medical Chemistry and Biochemistry, University of Innsbruck, Austria.
Insights
Moderate hyperhomocysteinemia, linked to cardiovascular and neurodegenerative diseases, may stem from B-vitamin deficiencies and immune system activation. Understanding homocysteine
Area of Science:
- Biochemistry
- Immunology
- Pathology
Background:
- Moderate hyperhomocysteinemia increases risks for atherosclerosis, thrombosis, and neurodegenerative diseases.
- Homocysteine accumulation results from genetic factors and B-vitamin status, impacting disease pathogenesis.
- The precise role of homocysteine in disease, including oxidative stress and endothelial dysfunction, requires further clarification.
Purpose of the Study:
- To explore the mechanisms linking homocysteine to disease development.
- To investigate whether observed effects are due to homocysteine or B-vitamin deficiencies (folate and vitamin B12).
- To examine the association between homocysteine metabolism, oxidative stress, and immune activation in diseases like Alzheimer's, rheumatoid arthritis, and vascular diseases.
Main Methods:
- Review of proposed mechanisms of homocysteine action.
- Analysis of the interplay between genetic predisposition, B-vitamin status, and homocysteine levels.
- Investigation of the role of immune system activation, particularly Th1-type responses and interferon-gamma, in homocysteine metabolism.
Main Results:
- Hyperhomocysteinemia is frequently observed with B-vitamin deficiencies in patients with enhanced immune activation.
- Immune cell proliferation increases B-vitamin demand, leading to homocysteine accumulation.
- Activated macrophages produce reactive oxygen species (ROS), oxidizing antioxidants and B-vitamins, potentially contributing to hyperhomocysteinemia.
Conclusions:
- Th1-type immune responses may significantly contribute to hyperhomocysteinemia development.
- Immune activation is a potential key determinant in the progression of diseases associated with hyperhomocysteinemia.
- Distinguishing homocysteine's direct effects from those of B-vitamin deficiency is crucial for understanding disease pathogenesis.
Abstract:
Moderate hyperhomocysteinemia is associated with an increased risk of atherosclerosis, thrombosis and neurodegenerative diseases. Homocysteine accumulation in the blood can be due to many underlying causes, which may interact with each other, e.g. genetic disposition and B-vitamin status. The role of the sulfur-containing amino acid homocysteine in the pathogenesis of diseases remains unclear, even if many studies suggest a causal relationship between homocysteine-mediated processes like oxidative stress, NO-inactivation and endothelial deficiency and atherogenesis. Proposed mechanisms of action of homocysteine are discussed, and the question is addressed, whether effects that are attributed to homocysteine, are not rather the consequence of folate and vitamin B12-deficiency. Deficiency of these B-vitamins in parallel with moderate hyperhomocysteinemia is often found in patients with enhanced activation of the cellular immune system, like Alzheimer's disease, rheumatoid arthritis and also vascular diseases. In patients with these diseases an association between homocysteine metabolism, oxidative stress and immune activation exists. On the one hand proliferation of immunocompetent cells having an enhanced demand for B-vitamins leads to the accumulation of homocysteine. On the other hand macrophages stimulated by TH1-type cytokine interferon-gamma form reactive oxygen species (ROS), which oxidize antioxidants, lipoproteins and oxidation-sensitive B-vitamins. Thereby Th1-type immune response could contribute importantly to the development of hyperhomocysteinemia, and may also be a major determinant of disease progression.
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