Hyperhomocysteinemia: Clinical Insights.
Hyperhomocysteinemia: Clinical Insights.
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DOI：
10.1177/1179573520962230
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发表时间：
2020
影响因子：
4.8
通讯作者：
Al Mutairi F
中科院分区：
文献类型：
--
作者：
Al Mutairi F
同型半胱氨酸（Hcy）是一种含巯基的氨基酸，是蛋氨酸（Met）代谢为半胱氨酸（Cys）的中间代谢产物，蛋氨酸代谢缺陷可使Hcy升高。高同型半胱氨酸血症（HHcy）对人类健康的影响已得到充分描述，并与多种临床状况相关。HHcy被认为是常见心血管和中枢神经系统疾病的独立危险因素，其在叶酸代谢和胆碱催化剂中的作用是许多代谢途径的基础。高同型半胱氨酸通过增加促炎细胞因子和下调抗炎细胞因子而诱导炎症反应，从而导致同型半胱氨酸诱导的细胞凋亡。有证据表明，同型半胱氨酸相关性脑血管病的发展可以通过维持正常的Hcy水平来预防。在这篇综述中，我们讨论了与HHCy相关的常见疾病和生化诊断检查，这可能有助于在早期阶段做出诊断。此外，未来的系统研究需要在细胞水平上证明HHcy的确切病理生理机制以及降低Hcy药物对疾病进程的影响。
Homocysteine (Hcy) is a sulfhydryl-containing amino acid, and intermediate metabolite formed in metabolising methionine (Met) to cysteine (Cys); defective Met metabolism can increase Hcy. The effect of hyperhomocysteinemia (HHcy) on human health, is well described and associated with multiple clinical conditions. HHcy is considered to be an independent risk factor for common cardiovascular and central nervous disorders, where its role in folate metabolism and choline catabolism is fundamental in many metabolic pathways. HHcy induces inflammatory responses via increasing the pro-inflammatory cytokines and downregulation of anti-inflammatory cytokines which lead to Hcy-induced cell apoptosis. Conflicting evidence indicates that the development of the homocysteine-associated cerebrovascular disease may be prevented by the maintenance of normal Hcy levels. In this review, we discuss common conditions associated with HHcy and biochemical diagnostic workup that may help in reaching diagnosis at early stages. Furthermore, future systematic studies need to prove the exact pathophysiological mechanism of HHcy at the cellular level and the effect of Hcy lowering agents on disease courses.