Moderate hyperhomocysteinaemia and immune activation in patients with rheumatoid arthritis

Schroecksnadel, Katharina; Frick, Barbara; Kaser, Sabine; Wirleitner, Barbara; Ledochowski, Maximilian; Mur, Erich; Herold, Manfred; Fuchs, Dietmar

doi:10.1016/j.cccn.2003.09.003

Cited by 58 publications

(56 citation statements)

References 27 publications

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“…In stimulated peripheral blood mononuclear cells in vitro, the production of neopterin and of homocysteine occurs in parallel (6). Likewise, in several clinical conditions, significant positive correlations were observed between concentrations of total homocysteine and neopterin (6,8,30), and in patients with coronary artery disease, significant inverse associations were observed between concentrations of neopterin and antioxidant compounds, such as vitamins C and E, and lycopene (31) or serum selenium content (32). Like the increase of homocysteine concentrations, the increase of neopterin levels was also associated with nonsurvival (17).…”

Section: Discussionmentioning

confidence: 95%

“…Likewise, in patients with cardiovascular, neurodegenerative and autoimmune disorders, rather close associations have been described between the concentrations of total homocysteine and immune activation and inflammation markers: for example, neopterin (7,8) and C-reactive protein (9), which themselves are significant predictors of cardiovascular risk (10)(11)(12). Neopterin concentrations serve as a reliable immune response marker because a great amount of neopterin is released by monocyte-derived macrophages and dendritic cells upon stimulation with Th1-type cytokine interferon-γ (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Early Increase of Plasma Homocysteine in Sepsis Patients with Poor Outcome

Ploder

Kurz

Spittler

et al. 2010

Mol Med

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Moderate hyperhomocysteinemia is a well-established coronary risk factor that develops when dietary supply with folate and/or vitamin B 12 is inadequate. Recently, stimulated peripheral blood mononuclear cells were shown to produce homocysteine. Thus, the stimulated immune system may contribute to moderate hyperhomocysteinemia during certain diseases. Because multiple trauma and sepsis are accompanied by often strong inflammatory responses, we investigated whether hyperhomocysteinemia may develop in patients. Total homocysteine and cysteine concentrations were measured in 83 plasma specimens from 18 patients (14 men, 4 women; 15 posttrauma with sepsis and 3 with sepsis alone) every third day of follow-up. Finally results were compared with concentrations of cytokines tumor necrosis factor (TNF)-α and interleukin (IL)-6, the immune activation marker neopterin and the extent of tryptophan degradation as indicated by the kynurenine-to-tryptophan ratio (kyn/trp). Compared with baseline, average total homocysteine (P < 0.05, d 4-d 10) and cysteine (P < 0.05, d 7-d 13) concentrations increased during follow-up of patients. However, only the increase of homocysteine was related to the survival status: total homocysteine was significantly higher in nonsurvivors (P < 0.05, d 4 and d 10) than in survivors, whereas cysteine concentrations increased in both subgroups. Homocysteine correlated with kyn/trp but not with neopterin concentrations. Increase of total homocysteine is common in patients after trauma with unfavorable outcome. Because all patients received standardized enteral nutrition after the end of hypodynamic shock, inconsistent vitamin supply is unlikely to be the reason for hyperhomocysteinemia in some of the patients; rather, it is associated with a stronger proinflammatory response. Certainly, the number of patients in our study is still small and results can only be regarded as preliminary.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Early Increase of Plasma Homocysteine in Sepsis Patients with Poor Outcome

Ploder

Kurz

Spittler

et al. 2010

Mol Med

Self Cite

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“…In addition, a number of disorders suggested to benefit from treatment with fish oil are associated with low folate or with a marker of low folate status, homocysteine (Jacob et al, 1994). These disorders include Crohn's disease (Belluzzi et al, 1996;Chowers et al, 2000), rheumatoid arthritis (Kremer et al, 1987;Schroecksnadel et al, 2003), mania (Hasanah et al, 1997;Stoll et al, 1999a, b) and hostility (Stoney and Engebretson, 2000;Iribarren et al, 2004). One study suggests that folate, like fish oil, can lower triglycerides, LDL and cholesterol (Connor et al, 1993;McGregor et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

The relationship between folate and docosahexaenoic acid in men

et al. 2005

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Objective: Docosahexaenoic acid (DHA,, an essential omega 3 fatty acid, may protect against disorders of emotional regulation as well as cardiovascular disease. Animal studies demonstrate that dietary folate can increase tissue concentrations of DHA, although the literature, to date, includes no human studies examining the possibility that folate status may affect plasma DHA concentrations. The objective of this study is to determine if the blood concentrations of folate and DHA are correlated in humans. Design: Retrospective study. Setting: An American research hospital. Subjects: A total of 15 normal and 22 hostile and aggressive subjects, with a mean age of 38 years. Methods: Concentrations of plasma polyunsaturated essential fatty acids and red blood cell folate (RBC folate) were obtained prior to 1996, before American flour was enriched with folate. Results: RBC folate was significantly correlated with plasma DHA, r ¼ 0.57, P ¼ 0.005 in the aggressive group. Age, smoking and alcohol consumption did not alter the results. No other essential fatty acids were significantly associated with RBC folate in either group. Conclusions: The positive relationship between plasma DHA and RBC folate concentrations suggests that these two nutrients should be examined together in order to make the most accurate inferences about their relative contributions to disease pathogenesis. Our findings present one explanation why some conditions associated with hostility and low DHA status, such as cardiovascular disease and emotional disorders, are also associated with low folate status.

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“…One particular dietary component that has recently received much attention is folate, which is an essential co-factor for onecarbon transfers, necessary for protein and DNA methylation, and for nucleotide synthesis (4). Folate deficiency is associated with several disorders of the cellular immune system, including Alzheimer's disease, rheumatoid arthritis and cardiovascular disease (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Study of Folate Status Among Egyptian Asthmatics

et al. 2011

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Objective To compare serum folate levels between atopic asthmatics, non-atopic asthmatics, and healthy controls. Methods This case-control study included 60 asthmatics with at least one positive skin prick test (SPT) reaction (atopic asthma group), 60 asthmatics with negative SPT reactions (non-atopic asthma group), and 60 healthy controls with no history of asthma or other allergic diseases, and with negative SPT reactions. Serum folate and total IgE levels were measured in all subjects. In addition, lung functions were assessed by spirometry. Results Serum folate levels were significantly lower among the atopic asthma group [9.1 (4.9, 12.1) ng/ mL] as compared to the non-atopic asthma group [11.3 (7.5, 14.8) ng/mL] and the control group [12.0 (8.3, 15.1) ng/mL], p= 0.001. Among atopic asthmatics, serum folate levels were inversely correlated with total serum IgE levels (r=-0.483, p<0.001), and the number of positive SPT reactions (r=-0.442, p<0.001). Atopic asthmatics with a total serum IgE !200 IU/mL had significantly higher levels of serum folate than those with a total serum IgE >200 IU/mL. Regression analysis showed that higher folate levels independently predicted lower total serum IgE levels. Folate was not found to be an independent predictor of asthma. No association was observed between serum folate levels and values of forced expiratory volume in 1s. Conclusion Among asthmatics, serum folate levels are significantly lower among atopics, and correlate inversely with the degree of atopy.

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Moderate hyperhomocysteinaemia and immune activation in patients with rheumatoid arthritis

Cited by 58 publications

References 27 publications

Early Increase of Plasma Homocysteine in Sepsis Patients with Poor Outcome

Early Increase of Plasma Homocysteine in Sepsis Patients with Poor Outcome

The relationship between folate and docosahexaenoic acid in men

Study of Folate Status Among Egyptian Asthmatics

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