Therapy of Hyperhomocysteinemia in Hemodialysis Patients: Effects of Folates and N-Acetylcysteine

Perna, Alessandra F.; Violetti, Eleonora; Lanza, Diana; Sepe, Immacolata; Bellinghieri, Guido; Savica, Vincenzo; Santoro, Domenico; Satta, Ersilia; Cirillo, Giovanni; Lupo, Antonio; Abaterusso, Cataldo; Raiola, Ilaria; Coppola, Salvatore; Iorio, Biagio Di; Tirino, Giuseppina; Cirillo, Massimo; Ingrosso, Diego; Santo, Natale G. De

doi:10.1053/j.jrn.2011.10.007

Cited by 15 publications

(13 citation statements)

References 21 publications

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“…[21][22][23] Kasperczyk et al 33 showed that chronic oral treatment with NAC decreased Hcy levels and oxidative stress in a dose-dependent manner in leadexposed workers. Similar with this study, NAC reduced Hcy levels in hemodialysis patients, [44][45][46] kidney transplant recipients, 47 patients with coronary artery disease, 48 and patients undergoing cardiac angiography. 49 These effects of NAC can be explained by removing of Hcy from protein binding sites, especially from circulating albumin.…”

Section: Effects Of Nac Administration On Hcy Levelssupporting

confidence: 84%

The Effects of N-acetylcysteine on Inflammatory Markers and Homocysteine: A Systematic Review and Meta-analysis of Randomized Controlled Trials

et al. 2020

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Background: Recently a number of trials investigated the effect of N-acetylcysteine (NAC) administration on inflammatory markers and homocysteine (Hcy). However, their fi ndings are controversial. The aim of this paper is to present a meta-analysis and give a review of all randomized controlled trials (RCTs) in order to determine the effects of NAC on inflammatory markers and Hcy. Methods: An electronic search was conducted using PubMed, Scopus, Cochrane Library, Google scholar and Web of Science databases from inception until April 2019. A study quality assessment was performed using the Jadad scale and heterogeneity between studies was statistically computed using Cochrane's Q test and I-square (I2). Data were pooled using a random-effects model and weighted mean difference (WMD) was considered as th e ov erall effect size. Results: Out of 1115 potential citations, 10 studies (reported 13 effect sizes for different parameters) met the inclusion criteria and were eligible for this meta-analysis. NAC supplementation resulted in a significant reduction in Hcy levels (WMD: -2.05; 95% CI: -3.73, -0.37). NAC administration did not affect C-reactive protein (CRP) levels (WMD: 0.06; 95% CI: -0.21, 0.34), tumor necrosis factor-α (TNF-α) levels (WMD: 0.07; 95% CI: -0.27, 0.40), and interleukin 6 (IL-6) (WMD: -0.23; 95% CI: -1.23, 0.77). Conclusion:It could be concluded that this meta-analysis of RCTs demonstrated that NAC administration to various patients significantly improved circulating Hcy, but did not affect CRP IL-6 and TNF-α levels.

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Section: Effects Of Nac Administration On Hcy Levelssupporting

confidence: 84%

The Effects of N-acetylcysteine on Inflammatory Markers and Homocysteine: A Systematic Review and Meta-analysis of Randomized Controlled Trials

et al. 2020

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“…This explains the reduction of the plasma total homocysteine level seen in the rats that were supplemented with folate in the present study. Folate supplementation has been reported by other researchers to significantly reduce plasma homocysteine level in experimental animals [14, 30] and humans [31, 32]. …”

Section: Discussionmentioning

confidence: 98%

Palm Tocotrienol-Rich Fraction Improves Vascular Proatherosclerotic Changes in Hyperhomocysteinemic Rats

Norsidah

Asmadi

Ayob³

et al. 2013

Evidence-Based Complementary and Alternative Medicine

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This study investigated the effects of palm tocotrienol-rich fraction (TRF) on aortic proatherosclerotic changes in rats fed with a high methionine diet. Forty-two male Wistar rats were divided into six groups. The first group was the control (fed with a basal diet). Another five groups were fed with 1% methionine diet for 10 weeks. From week 6 onward, folate (8 mg/kg diet) or palm TRF (30, 60, and 150 mg/kg diets) was added into the diet of the last four rat groups, respectively. The high methionine diet raised the plasma total homocysteine and aortic lipid peroxidation, which were reduced by the palm TRF and folate supplementations. Plasma nitric oxide was reduced in the high methionine group compared to the control (3.72 ± 0.57 versus 6.65 ± 0.53 μmol/L, P < 0.05), which reduction was reversed by the palm TRF (60 and 150 mg/kg) and folate supplementations. The increased aortic vascular cell adhesion molecule-1 expression in the methionine group (2.58 ± 0.29) was significantly reduced by the folate (1.38 ± 0.18) and palm TRF at 150 mg/kg (1.19 ± 0.23). Palm TRF was comparable to folate in reducing high methionine diet-induced plasma hyperhomocysteinemia, aortic oxidative stress, and inflammatory changes in rats.

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“…In view of the oxidative damage caused by Hcy, antioxidant therapies have also been considered. N-acetyl cysteine (NAC), has been used to replenish the depleting glutathione levels and thus has been used as a therapeutic option for combating HHcy [ 116 , 117 ]. Among others, NAC has been widely used for several years in the treatment of chronic obstructive pulmonary disease.…”

Section: Therapeutic Optionsmentioning

confidence: 99%

The metabolism and significance of homocysteine in nutrition and health

et al. 2017

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An association between arteriosclerosis and homocysteine (Hcy) was first demonstrated in 1969. Hcy is a sulfur containing amino acid derived from the essential amino acid methionine (Met). Hyperhomocysteinemia (HHcy) was subsequently shown in several age-related pathologies such as osteoporosis, Alzheimer’s disease, Parkinson’s disease, stroke, and cardiovascular disease (CVD). Also, Hcy is associated with (but not limited to) cancer, aortic aneurysm, hypothyroidism and end renal stage disease to mention some. The circulating levels of Hcy can be increased by defects in enzymes of the metabolism of Met, deficiencies of vitamins B6, B12 and folate or by feeding Met enriched diets. Additionally, some of the pharmaceuticals currently in clinical practice such as lipid lowering, and anti-Parkinsonian drugs are known to elevate Hcy levels. Studies on supplementation with folate, vitamins B6 and B12 have shown reduction in Hcy levels but concomitant reduction in certain associated pathologies have not been definitive. The enormous importance of Hcy in health and disease is illustrated by its prevalence in the medical literature (e.g. > 22,000 publications). Although there are compelling data in favor of Hcy as a modifiable risk factor, the debate regarding the significance of Hcy mediated health effects is still ongoing. Despite associations between increased levels of Hcy with several pathologies being well documented, whether it is a causative factor, or an effect remains inconclusive. The present review though not exhaustive, is focused on several important aspects of Hcy metabolism and their relevance to health.

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Therapy of Hyperhomocysteinemia in Hemodialysis Patients: Effects of Folates and N-Acetylcysteine

Cited by 15 publications

References 21 publications

The Effects of N-acetylcysteine on Inflammatory Markers and Homocysteine: A Systematic Review and Meta-analysis of Randomized Controlled Trials

The Effects of N-acetylcysteine on Inflammatory Markers and Homocysteine: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Palm Tocotrienol-Rich Fraction Improves Vascular Proatherosclerotic Changes in Hyperhomocysteinemic Rats

The metabolism and significance of homocysteine in nutrition and health

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