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Biomarkers in Cardiovascular Disease pp 381–406Cite as

Homocysteine as a Biomarker in Vascular Disease

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Abstract

Elevated concentrations of homocysteine (Hcy) result from either mutations in the genes encoding Hcy-metabolizing enzymes or from deficiencies of their cofactors. Even a mild increase in the levels of Hcy is considered a risk factor for a number of diseases in humans, such as cardiovascular disease, stroke, neurodegenerative disorders like dementia and Alzheimer’s disease, birth defects, complicated pregnancies, and bone fractures. However, it has not yet been elucidated whether Hcy is a causative agent. Here, we present an overview of recent data on the putative mechanisms of Hcy in hyperhomocysteinemia-related vascular diseases. However, the mechanism by which Hcy can promote atherogenesis remains unclear. Endothelial dysfunction is the central condition on which a number of factors converge. Increased oxidative stress with alterations in nitric oxide, protein thiolation, and homocysteinylation, as well as Hcy-induced epigenetic changes, are involved in the pathogenesis. Although combined folic acid and B-vitamin therapy substantially reduces Hcy levels, the results are mixed from most clinical trials testing the benefit of vitamin supplementation on cardiovascular events, but they have generally failed to show a significant effect.

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Abbreviations

5-MTHF:

5-methyltetrahydrofolate

ADMA:

Asymmetric dimethylarginine

CBS:

Cystathionine β-synthase

CSE:

Cystathionine γ-lyase

eNOS:

Endothelial nitric oxide synthase

ER:

Endoplasmic reticulum

GSH:

Glutathione

Hcy:

Homocysteine

HDL:

High density lipoprotein

HHcy:

Hyperhomocysteinemia

iNOS:

Inducible nitric oxide synthase

MAT:

Methionine adenosyltransferase

MTHFR:

Methylenetetrahydrofolate reductase

MTs:

Methyltransferase

NFκB:

Nuclear factor –kappa B

NO:

Nitric oxide

NOS:

Nitric oxide synthase

ROS:

Reactive oxygen species

SAH:

S-adenosylhomocysteine

SAM:

S-adenosylmethionine

tHcy:

Total homocysteine

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Authors and Affiliations

  1. Faculty of Medicine, Department of Pediatrics, Obstetrics and Ginecology, University of Valencia, Valencia, Spain

    Pilar Codoñer-Franch

  2. Faculty of Medicine, Department of Biochemistry and Molecular Biology, University of Valencia, Valencia, Spain

    Eulalia Alonso-Iglesias

Authors
  1. Pilar Codoñer-Franch
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  2. Eulalia Alonso-Iglesias
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Correspondence to Pilar Codoñer-Franch .

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Editors and Affiliations

  1. Department of Biomedical Science, Faculty of Science & Technology , University of Westminster, London, United Kingdom

    Vinood B. Patel

  2. Department of Nutrition and Dietetics, Division of Diabetes and Nutritional Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom

    Victor R. Preedy

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Codoñer-Franch, P., Alonso-Iglesias, E. (2016). Homocysteine as a Biomarker in Vascular Disease. In: Patel, V., Preedy, V. (eds) Biomarkers in Cardiovascular Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7678-4_11

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