Treatment of hyperhomocysteinemia in pediatric heart transplant recipients

Metabolic Groups Related to Blood Vitamin Levels and Inflammatory Biomarkers in Brazilian Children and Adolescents

“…Higher riboflavin and cobalamin plasma levels were consistently associated with decreased levels of tHcy and reduced CVD risk (56)(57)(58)(59)(60). Significant decreases in tHcy concentration occur after vitamin supplementation (vitamin B12, vitamin E, vitamin A and folic acid) in pediatric heart transplant patients with tHcy levels higher than normal (61,62). Others have shown that intake of vitamin B6 below EAR/AI was associated with low pyridoxal plasma levels which may increase homocysteine levels (63).…”

Pediatric Coronary Allograft Vasculopathy-A Review of Pathogenesis and Risk Factors

“…86,88,89 Treatment of both adult and pediatric patients with folic acid has been shown to decrease Hcy levels in patients with abnormally high Hcy levels. 90,91 In adults, this led to improved survival 7-years posttreatment, although the benefit may not be exclusively related to a decrease in cardiovascular events. 92 Hcy and treatment of hyperhomocysteinemia warrant further study in pediatric CAV.…”

“…The exact mechanism through which Hcy affects CAV remains unclear; however, Hcy is known to damage vascular endothelium through prooxidative pathways leading to impaired endothelial vasodilation and intimal hyperplasia 86,88,89 . Treatment of both adult and pediatric patients with folic acid has been shown to decrease Hcy levels in patients with abnormally high Hcy levels 90,91 . In adults, this led to improved survival 7‐years posttreatment, although the benefit may not be exclusively related to a decrease in cardiovascular events 92 .…”

Homocisteína, vitaminas do complexo B e perfil de ácidos graxos em crianças e adolescentes

“…Assim, apesar de haver alguns estudos prospectivos e revisões conflitantes que não verificaram associação entre as concentrações de Hcy e doenças cardíacas (EVANS et al, 1997;LEWIS, EBRAHIM, DAVEY SMITH, 2005;LONN et al, 2006 (CHANG et al, 2003;PAPANDREOU et al, 2006;KUMAR et al, 2017), maior circunferência da cintura (PAPANDREOU et al, 2006;SILVA et al, 2013), maiores níveis de pressão arterial (GLOWINSKA et al, 2003;PAPANDREOU et al, 2006) (LIMPACH et al, 2000;PARISI et al, 2003;MONTEIRO et al, 2014;RASZEWSKI et al, 2016) No estudo de Kelly et al, (2003), foi possível evidenciar associação inversa entre PLP e infarto isquêmico, com influência protetora do PLP em indivíduos com concentrações mais altas, independente da concentração de Hcy. Em estudo posterior, Kelly et al, (2004) observaram relação inversa entre as concentrações de vitamina B6 e proteína C reativa, explicando parcialmente a associação existente entre baixas concentrações de PLP, inflamação e doença vascular.…”