Evaluation of Serum Homocysteine and Leptin Levels in Patients with Uveitis

Abstract

Objectives:To evaluate the serum homocysteine (Hcy) and leptin levels in patients with uveitis.Ma­te­ri­als and Met­hods:The 70 cases included in the study comprised 3 groups: patients with Behçet’s uveitis (BU), patients with non-Behçet’s uveitis (NBU) and healthy controls. Body mass index was calculated for each subject. Serum Hcy and leptin levels were measured. Furthermore, acute-phase reactants including erythrocyte sedimentation rate (ESR), C-reactive protein and neutrophil count were measured.Re­sults:Serum Hcy levels were 15.04±4.59 µmol/L in the BU group, 15.4±6.87 µmol/L in the NBU group and 13.64±4.72 µmol/L in the control group (p>0.05). The serum leptin levels of male patients in the BU group, NBU group and control group were 4.76±3.54 ng/ml, 6.33±3.74 ng/ml and 5.47±6.33 ng/ml, respectively (p>0.05). When we compared serum leptin levels in female patients and controls, the mean serum leptin concentrations were significantly higher in female BU and NBU patients (24.83±17.62 ng/ml and 28.46±13.90 ng/ml, respectively) than in healthy control volunteers (9.62±6.36 ng/ml, p<0.05). In addition, the ESR value differences between groups were statistically significant (p<0.05).Conclusion:A larger case series is necessary to investigate serum Hcy and leptin concentrations in uveitis patients.

Plasma Homocysteine in Behcet's Disease: A Systematic Review and Meta-Analysis

“…The initial database search yielded 184 entries plus another 2 found on Google; following the screening and exclusion processes indicated in Fig. 1 , we identified 53 studies (52 full papers and one abstract) 6 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 examining the relationship between HC and BD (48 case–control and 5 cohort studies) that were included in our systematic review and meta-analysis ( Table 1 ). Of the 48 case–control studies, one did not report the mean ages of participants 22 and another did not report gender data (both full papers), 31 whereas a third (in abstract form only) did not report the mean ages and the gender data 40 : two missing data each for mean age of participants and for male/female ratio (4.1%) are unlikely to compromise the results of the sensitivity analysis; of the five cohort studies one did not report the mean age of participants.…”

“…Nine articles explored the relationship between HC and ocular involvement; a preliminary analysis revealed one study dealing with inactive BD patients in both groups 53 and one article using as controls uveitis patients due to conditions other than BD, 54 so we pooled data from seven articles comparing HC in 165 BD patients without ocular involvement and 123 with such involvement; the effect size favored ocular involvement ( p < 0.0001) with moderate heterogeneity ( I 2 = 40.3%, p = 0.12) ( Fig. 5 ) that dropped to nil after removal of one outlier study that included the whole spectrum of ocular involvement.…”

A Role for Folate in Microbiome-Linked Control of Autoimmunity

“…Folate as one of the colonic bacterial fermentation products is a powerful micronutrient with a broad spectrum of wellknown functions at various levels. Its importance in ocular health is well established [144][145][146][173][174][175][176][177][178][179], but its immunomodulatory properties represent an emerging concept for functional T reg stabilization. The colon is a significant folate depot [19] that participates in metabolism and contributes to bioavailable folate levels.…”

“…Of those miRNAs highlighted, miRNA-223 stood out, as it not only promoted an inflammatory response through activation of DC and T cells but also hinted at a dysbiotic microbiome [141][142][143] with reduced colonic folate synthesis/bioavailability. Interestingly, hyperhomocysteinaemia, and its underlying polymorphisms in folate metabolism-associated genes [144], occurs in autoinflammatory (Behçet's) uveitis patients [145] indicating a link for FA in noninfectious uveitis [146].…”

Immune Privilege: The Microbiome and Uveitis

“…FA deficiency is intrinsically damaging to the eye and has been linked to amblyopia (192), optic neuropathy (193), senile cataracts (194), and retinal hyper-homocysteinemia (195) along with its secondary complications (196)(197)(198). Hyperhomocysteinemia is connected to specific polymorphisms in FA metabolism-associated genes (199) and has been reported to occur in autoinflammatory BD patients (200). A role for FA in autoimmune uveitis is therefore recognized [for review see (201)].…”