同型半胱氨酸化与疾病

高同型半胱氨酸血症能引起多种疾病如动脉粥样硬化、恶性肿瘤、神经退行性疾病等。研究发现,同型半胱氨酸(homocysteine,Hcy)能诱导氧化应激、内质网应激、蛋白质聚集。然而,具体的分子机制还有待进一步研究。近年来,蛋白质的同型半胱氨酸化引起广泛关注,本文对Hcy的代谢途径、同型半胱氨酸化及对机体的影响予以综述。     

高同型半胱氨酸对动脉粥样硬化形成的作用

同型半胱氨酸是甲硫氨酸的中间代谢产物,高同型半胱氨酸血症已成为动脉粥样硬化的一种独立危险因素,探讨高同型半胱氨酸血症形成的原因及同型芈胱氨酸致动脉粥样硬化的机制,有助于动脉粥样硬化的防治.     

常用抗癫痫药对癫痫患者血同型半胱氨酸的影响

目的:观察常用抗癫痫药对癫痫患者血同型半胱氨酸、叶酸、维生素B12浓度的影响。方法:比较45例服用单药治疗的癫痫患者(服用卡马西平11例,服用拉莫三嗪12例,服用奥卡西平9例,服用丙戊酸13例)血同型半胱氨酸、叶酸、维生素B12浓度的差异。结果:癫痫患者血同型半胱氨酸均高于正常,而叶酸和维生素B12均在正常范围内;服用拉莫三嗪的患者其血中同型半胱氨酸低于服用丙戊酸、卡马西平和奥卡西平的患者;服用卡马西平的患者血中叶酸高于服用拉莫三嗪、丙戊酸的患者(P<0.05);维生素B12在各用药组间无统计学差异。结论:长期服用抗癫痫药物可引起血中同型半胱氨酸的升高,而高同型半胱氨酸血症可增加心脑血管疾病的危险,故癫痫患者应常规给予补充叶酸、维生素B12,以使血同型半胱氨酸水平恢复正常。     

同型半胱氨酸在心血管疾病中的免疫调节作用

高同型半胱氨酸血症是动脉粥样硬化的独立危险因子,但是其致病机制尚未完全阐明。本文将从体液免疫、单核巨噬细胞以及T细胞活性等几方面归纳总结同型半胱氨酸在心血管疾病中的免疫调节作用。同型半胱氨酸可以诱导单核细胞和T细胞分泌趋化因子和细胞因子,还可以直接刺激B细胞增殖及IgG分泌。此外,本文还总结了高同型半胱氨酸致炎作用的细胞内机制。同型半胱氨酸可以直接或间接导致氧化应激或者内质网应激,还可以降低一氧化氮的生物活性,影响包括S-腺苷蛋氨酸和S-腺苷同型半胱氨酸的水平,从而导致心血管疾病的发生。     

同型半胱氨酸对蛋白质的修饰作用研究进展

高同型半胱氨酸血症在心血管疾病、孕期并发症、认知障碍和骨质疏松症等疾病发生发展过程中是一个独立的危险因子,同型半胱氨酸的致病机制相关研究一直受到科研工作者的广泛关注.本综述主要介绍新近国际科研界热点,即以蛋白质同型半胱氨酸化为中心的假设理论.该理论以同型半胱氨酸的分子化学性质为基础,通过两种基本的蛋白质修饰途径,较好地解释了蛋白质的结构和功能损伤之间的关系,而这种对蛋白质的修饰所造成的血管性损伤也许正是引起上述多种不甚相关疾病的共同关键机制.     

高同型半胱氨酸血症致动脉粥样硬化的细胞分子机制

同型半胱氨酸（homocysteine,Hcy)是蛋氨酸代谢途径产生的含硫氨基酸,其代谢紊乱可以诱导高同型半胱氨酸血症的发生,已被临床及流行病学资料证实为动脉粥样硬化发病的独立危险因子。Hcy通过激活二酰甘油－蛋白激酶C－（DAG－PKC）及丝裂素活化蛋白激酶（MAPK）途径,诱导相关基因的表达,促进细胞钙化,启动脂质过氧化应激,从而损伤心血管系统。金属硫蛋白,牛磺酸,L－精氨酸作为内源性小分子物质,成为继维生素B6,B12之后控制和治疗高同型半胱氨酸血症的新途径。     

同型半胱氨酸与冠心病

随着社会的进步以及人类生活水平的提高,冠心痛的发病率也逐年提高,目前已经成为全球死亡率最高的疾病之一,同时医学水平的不断发展也使得人们对冠心病有了更进一步的研究.近年来同型半胱氨酸越来越受到人们的关注,众多研究表明,高同型半胱氨酸血症是冠心痛的独立危险因子,可以影响冠心病的严重程度及预后.但是迄今为止,同型半胱氨酸在冠心病发病中的确切机制尚不完全明确,认为主要与血管内皮损伤、血管平滑肌细胞增殖凋亡、破坏凝血纤溶系统、影响糖、蛋白质、脂质代谢等方面有关.针对高同型半胱氨酸血症的治疗,对于改善冠心病患者的预后有一定疗效.因此,本文就同型半胱氨酸冠心痛的关系作一综述,从而为临床更好的防治冠心痛提供相关的资料.     

同型半胱氨酸致动脉粥样硬化的作用机制及最新进展

1969年,在研究患有同型半胱氨酸遗传代谢疾病的儿童血管生理时,首次提出了动脉粥样硬化的同型半胱氨酸理论。事实上,自从1969年发现动脉粥样硬化的同型半胱氨酸理论后,许多回顾与展望人类的观察性研究已经将高同型半胱氨酸血症作为动脉粥样硬化的一个独立危险因素。本文主要从以下几个方面探讨同型半胱氨酸致动脉粥样硬化的作用机制:氧化应激,内皮功能障碍和炎症;微生物,脂蛋白和脆性斑块的形成;基质金属蛋白酶和基质金属蛋白酶2。     

拉萨地区血浆同型半胱氨酸水平与脑梗死的相关性研究

目的：探讨在高原缺氧环境下,研究血浆同型半胱氨酸水平与脑梗死的相关性及临床意义,为高原地区脑梗死的防治提供依据。方法：随机选取西藏自治区人民医院2011年04月-2012年12月入院治疗的急性脑梗死患者166例作为观察组,选择同期就诊的150例健康检查者作为对照组,患者就诊第二日清晨采空腹静脉血送检。血浆同型半胱氨酸水平应用循环酶法测定,分析同型半胱氨酸水平与脑梗死的相关性。结果：观察组患者血浆中同型半胱氨酸水平明显高于对照组,差异显著具有统计学意义（P〈0．01）。结论：高原环境下,高同型半胱氨酸血症是脑梗死的独立危险因素,血浆同型半胱氨酸水平可作为脑血管疾病一级预防的常规检查指标,以及对缺血性脑卒中的指导治疗有重要意义。     

拉萨地区血浆同型半胱氨酸水平与脑梗死的相关性研究

目的:探讨在高原缺氧环境下,研究血浆同型半胱氨酸水平与脑梗死的相关性及临床意义,为高原地区脑梗死的防治提供依据。方法:随机选取西藏自治区人民医院2011年04月-2012年12月入院治疗的急性脑梗死患者166例作为观察组,选择同期就诊的150例健康检查者作为对照组,患者就诊第二日清晨采空腹静脉血送检。血浆同型半胱氨酸水平应用循环酶法测定,分析同型半胱氨酸水平与脑梗死的相关性。结果:观察组患者血浆中同型半胱氨酸水平明显高于对照组,差异显著具有统计学意义(P0.01)。结论:高原环境下,高同型半胱氨酸血症是脑梗死的独立危险因素,血浆同型半胱氨酸水平可作为脑血管疾病一级预防的常规检查指标,以及对缺血性脑卒中的指导治疗有重要意义。     

Roles of homocysteine in cell metabolism: old and new functions.

Mild hyperhomocysteinemia has been suggested as a new, independent risk factor for cardiovascular disease. This fact has produced a new, increased interest in the study of homocysteine metabolism and its relation to pathogenesis. This emergent area of biomedical research is reviewed here, stressing the biochemical and metabolic basis of the pathogenicity of increased levels of homocysteine.     

Molecular genetics of MTHFR: polymorphisms are not all benign

Methylenetetrahydrofolate reductase (MTHFR) is a key regulatory enzyme in folate and homocysteine metabolism. Research performed during the past decade has clarified our understanding of MTHFR deficiencies that cause homocystinuria or mild hyperhomocysteinemia. Our cloning of the MTHFR coding sequence was initially followed by the identification of the first deleterious mutations in MTHFR, in patients with homocystinuria and marked hyperhomocysteinemia. Shortly thereafter, we identified the 677C-->T variant and showed that it encoded a thermolabile enzyme with reduced activity. Currently, a total of 41 rare but deleterious mutations in MTHFR, as well as about 60 polymorphisms have been reported. The 677C-->T (Ala222Val) variant has been particularly noteworthy since it has become recognized as the most common genetic cause of hyperhomocysteinemia. The disruption of homocysteine metabolism by this polymorphism influences risk for several complex disorders, including cardiovascular disease, neural tube defects and some cancers. We describe here the complex structure of the MTHFR gene, summarize the current state of knowledge on rare and common mutations in MTHFR and discuss some relevant findings in a mouse model for MTHFR deficiency.     

Homocysteine attenuates endothelial haem oxygenase-1 induction by nitric oxide (NO) and hypoxia.

The disrupted metabolism of homocysteine (Hcy) causes hyperhomocysteinemia, a condition associated with the impairment of nitric oxide (NO) bio-availability, tissue hypoxia and increased risk of vascular disease. Here, we examined how Hcy modulates the induction of the stress protein haem oxygenase-1 (HO-1) evoked by NO releasing agents and hypoxia in vascular endothelial cells. We found that Hcy (0.5 mM) markedly reduced the increase in haem oxygenase activity and HO-1 protein expression induced by sodium nitroprusside (SNP, 0.5 mM) but did not affect HO-1 activation mediated by S-nitroso-N-acetyl-penicillamine. Cells pre-treated with Hcy followed by addition of fresh medium containing SNP still exhibited an augmented haem oxygenase activity. Interestingly, high levels of Hcy were also able to abolish hypoxia-mediated HO-1 expression in a concentration-dependent manner. These novel findings indicate that hyperhomocysteinemia interferes with crucial signaling pathways required by cells to respond and adapt to stressful conditions.     

Mechanisms of Toxic Effects of Homocysteine on the Nervous System

Neurophysiology - The review describes the metabolism of homocystein, causes of hyperhomocysteinemia, mechanisms underlying the respective negative effects on the nervous system, and main...     

Plasma homocysteine is decreased in the hypothyroid rat

Recent clinical studies have indicated that plasma homocysteine was significantly increased in hypothyroid patients. Since hyperhomocysteinemia is an independent risk factor for cardiovascular disease we investigated homocysteine metabolism in hypothyroid rats. Hypothyroidism was induced in one study by addition of propylthiouracil (PTU) to the drinking water for 2 weeks. In a second study, thyroidectomized and sham-operated rats were used with thyroid hormone replacement via mini-osmotic pumps. Unlike the human hypothyroid patients, both groups of hypothyroid rats exhibited decreased total plasma homocysteine (30% in PTU rats, 50% in thyroidectomized rats) versus their respective controls. Thyroid replacement normalised homocysteine levels in the thyroidectomized rat. Increased activities of the hepatic trans-sulfuration enzymes were found in both models of hypothyroidism. These results provide a possible explanation for the decreased plasma homocysteine concentrations. The hypothyroid rat cannot be used as a model to study homocysteine metabolism in hypothyroid patients.     

Effects of catechin on homocysteine metabolism in hyperhomocysteinemic mice

We have recently focused on the interaction between hyperhomocysteinemia, defined by high plasma homocysteine levels, and paraoxonase-1 expression and found a reduced activity of paraoxonase-1 associated with a reduced gene expression in the liver of cystathionine beta synthase (CBS) deficient mice, a murine model of hyperhomocysteinemia. As it has been demonstrated that polyphenolic compounds could modulate the expression level of the paraoxonase-1 gene in vitro, we have investigated the possible effect of flavonoid supplementation on the impaired paraoxonase-1 gene expression and activity induced by hyperhomocysteinemia and have evaluated the link with homocysteine metabolism. High-methionine diet significantly increased serum homocysteine levels, decreased hepatic CBS activity, and down-regulated paraoxonase-1 mRNA and its activity. However, chronic administration of catechin but not quercetin significantly reduced plasma homocysteine levels, attenuated the reduction of the hepatic CBS activity, and restored the decreased paraoxonase-1 gene expression and activity induced by chronic hyperhomocysteinemia. These data suggest that catechin could act on the homocysteine levels by increasing the rate of catabolism of homocysteine.     

Measurement of homocysteine and related metabolites in human plasma and urine by liquid chromatography electrospray tandem mass spectrometry

The sulfur amino acids, methionine and cysteine play crucial roles in cells as a substrate for protein synthesis, as a methyl donor, and for the synthesis of sulfur-containing compounds, including the key intracellular tripeptide, glutathione. Homocysteine is an intermediary metabolite formed during the metabolism of methionine to cysteine. Dysregulation of homocysteine metabolism is implicated in adverse clinical outcomes such as increased risk of cardiovascular disease, stroke, Alzheimer's disease dementia and osteoporosis. While hyperhomocysteinemia is commonly observed in those conditions, the impact on other related metabolites is condition-specific. Therefore, there exists a need to establish precise and sensitive analytical techniques that allow for the simultaneous measurement of homocysteine and related metabolites in biological samples. The current review outlines the development and use of liquid chromatography electrospray tandem mass spectrometry (LC–MS/MS) to simultaneously measure metabolites involved in sulfur amino acid metabolism. Additionally, extensions of the technique in relation to the measurement of sulfur amino acid and one-carbon kinetics in vivo are discussed. The LC–MS/MS technique has the capacity for unambiguous analyte identification and confirmation, due to its high specificity and sensitivity. It has the greatest potential of being accepted and utilized as a dedicated homocysteine and its related metabolite Standard reference method (SRM).     

On the mechanism of homocysteine pathophysiology and pathogenesis: a unifying hypothesis

Studies have shown that hyperhomocysteinemia is an important and independent risk factor for a variety of human cardiovascular diseases. In this paper, a unifying hypothesis is proposed which suggests that hyperhomocysteinemia may exert its pathogenic effects largely through metabolic accumulation of S-adenosyl-L-homocysteine, a strong noncompetitive inhibitor of the catechol-O-methyltransferase (COMT)-mediated methylation metabolism of various catechol substrates (such as catecholamines and catechol estrogens). In the case of endogenous catecholamines in peripheral tissues, inhibition of their methylation by S-adenosyl-L-homocysteine will result in elevation of blood or tissue levels of catecholamines, and consequently, over-stimulation of the cardiovascular system's functions. Moreover, because the vasculature is constantly exposed to high levels of endogenous catecholamines (due to high levels of circulating neurohormone epinephrine plus rich innervation with sympathetic nerve terminals), vascular endothelial cells would incur chronic cumulative damage caused by the large amounts of the oxidative products (catechol quinones/semiquinones and oxyradicals) generated from endogenous catecholamines. This mechanistic explanation for the vascular toxicity of hyperhomocysteinemia is supported by many experimental findings, and it also fully agrees with the known protective effects of folate, vitamins B6 and B12 in hyperhomocysteinemic patients. In addition, based on the predictable effects of hyperhomocysteinemia on the methylation of catecholamines in the central nervous system as well as on the methylation of catechol estrogens in estrogen target organs, it is also suggested that hyperhomocysteinemia is an important risk factor for the development of neurodegerative disorders (Parkinson's and Alzheimer's diseases) and estrogen-induced hormonal cancers. More studies are warranted to test these intriguing ideas.     

Homocysteine induces energy imbalance in rat skeletal muscle: Is creatine a protector?

Homocystinuria is a neurometabolic disease caused by a severe deficiency of cystathionine beta‐synthase activity, resulting in severe hyperhomocysteinemia. Affected patients present several symptoms including a variable degree of motor dysfunction. In this study, we investigated the effect of chronic hyperhomocysteinemia on the cell viability of the mitochondrion, as well as on some parameters of energy metabolism, such as glucose oxidation and activities of pyruvate kinase, citrate synthase, isocitrate dehydrogenase, malate dehydrogenase, respiratory chain complexes and creatine kinase in gastrocnemius rat skeletal muscle. We also evaluated the effect of creatine on biochemical alterations elicited by hyperhomocysteinemia. Wistar rats received daily subcutaneous injections of homocysteine (0.3–0.6 µmol/g body weight) and/or creatine (50 mg/kg body weight) from the 6th to the 28th days of age. The animals were decapitated 12 h after the last injection. Homocysteine decreased the cell viability of the mitochondrion and the activities of pyruvate kinase and creatine kinase. Succinate dehydrogenase was increased other evaluated parameters were not changed by this amino acid. Creatine, when combined with homocysteine, prevented or caused a synergistic effect on some changes provoked by this amino acid. Creatine per se or creatine plus homocysteine altered glucose oxidation. These findings provide insights into the mechanisms by which homocysteine exerts its effects on skeletal muscle function, more studies are needed to elucidate them. Although creatine prevents some alterations caused by homocysteine, it should be used with caution, mainly in healthy individuals because it could change the homeostasis of normal physiological functions. Copyright © 2012 John Wiley & Sons, Ltd.