Homocystine level in blood of patients with rheumatoid arthritis

Rheumatoid arthritis [RA] is an inflammatory disease. It largely affects synovial joints, which are lined with a specialized tissue called synovium. RA typically affects the small joints of the hands and the feet, and usually both sides equally and symmetrically, although any synovial joint can be affected. It is a systemic disease and so can affect the whole body, including the heart, lungs and eyes. There are approximately 400,000 people with RA in the UK, The incidence of the condition is low, with around 1.5 men and 3.6 women developing RA per 10,000 people per year. This translates into approximately 12,000 people developing RA per year in the UK. The overall occurrence of RA is two to four times greater in women than men. To assess total Homocystine [tHcy] metabolism and also levels of B vitamins [folate and B12] which is enters in remathelytion of Homocystine metabolism in blood of patient with rheumatoid arthritis. Forty patients with rheumatoid arthritis were studied. Their ages range from 20-80 years with a mean age of 47.2 +/- 12.9 years. Apparently healthy volunteers considered of 30 individuals who considered as control Blood samples were collected from patients and controls to assess serum concentration of homocystine were measured by [hplc], folate and B12 were measured by cobas e411, lipid profile [spectrophotometer] and different parameters. The current results revealed that serum Homocystine level was significantly higher in patients than in healthy controls [p=0.001]. More ever, there is significant negative association was found between serum Homocystine with folate and B12 also there is strong positive association between folate and B12. Elevated Hey levels in patients with RA, may explain some of the increased cardiovascular mortality seen in such patients. Studies of the prevalence and mechanism of hyperhomocysteinemia in RA are warranted simple preventive measures may reduce the risk cardio vascular disease such as dietary supplementation of adequate vitamins of folic acid and B12 from natural sources [fruits and green leafy vegetables], substitution of animal proteins by plant proteins in the diet, as animal proteins have higher methionine content than the plant proteins. This may, in part, decrease the body burden of Hey and regularize the deranged Hey metabolism in most cases

Serum asymmetric dimethyl arginine [ADMA], nitric oxide [NO] and homocystine [HCY] levels in behcet's disease as biomarkers of endothelial cell dysfunction

To measure the serum levels of asymmetric dimethyl arginine [ADMA], nitric oxide [NO] and homocystine [Hcy] in patients with Behcet's disease as markers of endothelial cell dysfunction and to explain their role [s] in the disease pathogenesis and activity. This study included 14 male patients with Behcet's's disease and 10 age and sex matched healthy volunteers. Patients were divided into two groups: mucocutaneous and vasculitis groups. CBC, deferential leucocytic counts, ESR, CRP were performed as a guide for disease activity. ADMA, NO and homocystine, was measured in the serum of all studied groups by ELISA. Duplex ultrasono graphics of venous and arterial system were done for vasculitis group. There was significant increase in ADMA level in BD patients [0.918 +/- 0.240 micro mol/L] than control group [0.0.401 +/- 0.070 micro mol/L] with increase in vasculitis group [1.133 +/- 0.223 micro mol/L] than mucocutaneous group [0.756 +/- 0.049 micro mol/L]. The study reported significant decrease in NO level in BD patients [11.986 +/- 1.815 micro mol] than the control group [14.560 +/- 1.897 micro mol/L] with significant decrease in vasculitis group [10.333 than +/- 0.647 micro mol/L] than mucocutaneous group [13.225 +/- 1.312 micro mol/L]. There was also significant increase in Hey level in BD patients [25.271 +/- 4.980 micro mol/L] than control group [10.020 +/- 1.060 micro mol/L] with significant increase in vasculitis group [30.53 3 +/- 1.141 micro mol/L] than mucocuteneous group [21.325 +/- 1.896 micro mol/L. Increased ADMA with decrease NO and increase Hcy serum levels may be responsible for endothelial damage in BD and can be used as markers for endothelial cell dysfunction

Homocysteine, an indicator of methylation pathway alternation in Down syndrome and its regulation by folic acid therapy

Down syndrome [DS] is a complex genetic disease. Some clinical features of patients with this syndrome could be related to functional folate deficiency. The purpose of this study was to evaluate the total homocysteine [T-Hcy] metabolism in DS children and to determine whether the supplementation with folic acid therapy would shift the genetically induced metabolic imbalance or not. Thirty-five infants with DS, with the mean age of 17.66 +/- 12.24 months were included in this study. They were selected from those attending the Genetic Outpatients Clinic in Children hospital. Our results revealed that Down syndrome children had a significant decrease in serum plasma T-Hcy level after the treatment with folic acid [11.79: +/- 0.92 vs. 14.41 +/- 4.93 micro mol/L]. A significant negative correlation was found between T-Hcy and folic acid serum levels [r = -0.112; P<0.05]. We concluded that the regulation of methylation pathways in Down syndrome patients becomes important in the light of possible normalization of the metabolic imbalance and the detection of increased sensitivity to therapeutic interventions

Homocystinuria with congenital/developmental cataract.

The aim of the study is to screen patients for homocystinuria with and without cataract and analyse for homocystine and methionine. Fifty-eight samples from 29 patients, i.e., plasma and urine collected after overnight fasting were analysed by the screening test for homocystine, and paper chromatography for homocystine and methionine. Out of 29 homocystinuric patients, 24 had cataract. Only one had appreciable amounts of methionine in his serum. He also had mental retardation as expected and belongs to Type I. The other types did not have methionine but had only homocystine. There was no mental retardation or ectopia lentis. So they belonged to Types II, III or IV. As there is excess methionine in Type I, with low cystine, cataract may be due to deficiency of cysteine and reduced glutathione and might be averted by suitable therapy, i.e., high cystine-low methionine diet with B6. In other types with low methionine, cataract may be due to decreased availability of amino acids for the synthesis of lens proteins; the treatment of choice should be B12, and folate with methionine.

Homocyst(e)ine and atherosclerosis in patients on chronic hemodialysis

Hyperhomocyst(e)inemia is an established risk factor for atherosclerosis. We performed this study to identify the correlating variables and risk factors for atherosclerosis, as measured by the atherosclerotic score (AS), and to determine the relative risk for cardiovascular disease in relation to plasma homocyst(e)ine levels in patients on chronic hemodialysis. We evaluated and measured 61 patients on chronic hemodialysis for clinical and biochemical parameters including atherosclerotic score (AS) and plasma homocyst(e)ine. We divided patients into high and low groups, first, by the mean AS, and second, by the median value of plasma total homocyst(e)ine levels. Then we compared the variables between the two groups. Out of the 61 patients, the median plasma total homocyst(e)ine level was 24.4 micromol/L (mean+/-SD, 27.7+/-17.4; range, 9.8-127.4 micromol/L), and the median AS was 5 (mean+/-SD, 6.2+/-2.8; range, 3-13) out of a possible 20 points. AS was significantly correlated with plasma total homocyst(e)ine levels (r=0.37) and age (r=0.67). Through multivariate analysis, plasma total homocyst(e)ine level and age were determined as significant risk factors for the high-AS group (p0.05). Eighteen of the 61 patients, presented with cardiovascular disease until the present study, had an AS>6. Cardiovascular disease was found more often in the high-homocyst(e)ine group (>24.4 micromol/L) than in the low-homocyst(e)ine group (odds ratio, 9.3; 95% confidence interval, 2.3-37.4). Regardless of age, hyperhomocyst(e)inemia (especially homocyst(e)ine levels >24.4 micromol/L) is a risk factor that can be modified for the development of cardiovascular disease in patients on chronic hemodialysis.