A Meta-Analysis of Plasma Homocysteine in Buerger's Disease

Abstract

Letter to the Editor 1243This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

Thromboangiitis obliterans: a review

“…It has been seen that it may predominate more in 45-year-old men from the East and smoking is a possible trigger; however, other factors such as cannabis consumption and genetic factors have been raised. 14,32 Diagnosis continues to be a challenge, since the findings tend to be non-specific or inconsistent with suspicion, which is why it is currently based on ruling out other causes such as atherosclerosis and vasculopathies. 11 With current evidence, there are many types of treatments, both pharmacological and nonpharmacological, with the greatest evidence of results being the suspension of tobacco consumption.…”

“…However, they point out that the increase in oxidative stress that accompanies Buerger's disease, whether mainly due to smoking or not, can inhibit cystathionine B-synthase, the first enzyme that catalyzes the transformation of homocysteine to cystathionine, so it can perpetuate and increase the homocysteine increasing oxidative stress and vascular damage; Therefore, they conclude that elevated homocysteine is more an effect of the inflammation that often accompanies Buerger's disease and is less likely to be a primary cause. 14 The pathological processes of Buerger's disease are not completely defined, but it is proposed to be multifactorial with the predominance of an immune response together with oxidative stress that triggers an inflammatory response and endothelial dysfunction with a procoagulant state (Figure 1). The processes related to oxidative stress in Buerger's disease are described.…”