III. Folate deprivation reduces homocysteine remethylation in a human intestinal epithelial cell culture model: role of serine in one-carbon donation. Am J Physiol Gastrointest Liver Physiol 286: G588-G595, 2004. First published November 13, 2003 10.1152/ajpgi.00454.2003Little is known about homocysteine metabolism in intestine. To address this question, we investigated homocysteine metabolism under conditions of folate adequacy and folate deprivation in the Caco-2 cell line, a model of human intestinal mucosal cells. Caco-2 cells were cultured in media enriched with [3-13 C]serine and [U-13 C5]methionine tracers, and enrichments of intracellular free amino acid pools of these amino acids as well as homocysteine, cystathionine, and cysteine were measured by using gas chromatography/mass spectrometry. Homocysteine transsulfuration plus folate-dependent and total remethylation were quantified from these amino acid enrichments. Homocysteine remethylation accounted for 19% of the intracellular free methionine pool in cells cultured with supplemental folate, and nearly all one-carbon units used for remethylation originated from the three carbon of serine via folate-dependent remethylation. Labeling of cystathionine and cysteine indicated the presence of a complete transsulfuration pathway in Caco-2 cells, and this pathway produced 13% of the intracellular free cysteine pool. Appearance of labeled homocysteine and cystathionine in culture medium suggests export of these metabolites from intestinal cells. Remethylation was reduced by one-third in folate-restricted cell cultures (P Ͻ 0.001), and only ϳ50% of the one-carbon units used for remethylation originated from the three carbon of serine under these conditions. In conclusion, the three carbon of serine is the primary source of one-carbon units used for homocysteine remethylation in folate-supplemented Caco-2 cell cultures. Remethylation is reduced as a result of folate restriction in this mucosal cell model, and one-carbon sources other than the three carbon of serine contribute to remethylation under this condition. methionine; methylation; Caco-2; transsulfuration; serine FOLATE DEFICIENCY AND GENETIC polymorphisms of several enzymes involved in one-carbon metabolism are linked to cardiovascular disease and certain cancers and particularly colorectal cancer (5, 6, 16, 18a). These associations are likely due to the effects of altered folate metabolism on homocysteine remethylation, DNA synthesis, and DNA methylation (3,11,29). Reduced homocysteine remethylation can result in elevated plasma homocysteine concentration, which is an independent risk factor for cardiovascular disease (19). Altered DNA metabolism is implicated in the etiology of cancers (20).Folate serves as a metabolic carrier of one-carbon units (8). In homocysteine remethylation, folate transports methyl groups as 5-methyltetrahydrofolate (5-CH 3 THF) to methionine synthase, the ubiquitous homocysteine methyltransferase that converts homocysteine to methionine in all cells (Fig. 1, reactions 6-8)...