Homocysteine is a variant of the amino acid cysteine, differing in that its side-chain contains an additional methylene (-CH2-) group before the thiol (-SH) group.
Homocysteine is formed from S-adenosyl methionine by a two step reaction pathway. It can be converted back to methionine, or converted to cysteine or taurine via the transsulfuration pathway. Although homocysteine can be converted back to methionine, there is no indication that dietary homocysteine contributes any methionine nutritionally to humans.
Elevations of homocysteine also occur in the rare hereditary disease homocystinuria and in methyl-tetrahydrofolate-reductase deficiency. The latter is quite common and usually goes unnoticed, although there are reports that thrombosis and cardiovascular disease occurs more often in people with elevated homocysteine.
Homocysteine appears to be downregulated by high concentrations of polyphenol antioxidants , chemicals which are known to provide certain health benefits to the cardiovascular system and immune system. These chemicals are known to down-regulate the formation of reactive oxygen species, key chemicals in cardiovascular disease.
Studies reported in 2006 have shown that giving vitamins acid, B6 and B12 to reduce homocysteine levels may not quickly offer benefit, however a significant 25% reduction in stroke was found in the HOPE-2 study even in patients mostly with existing serious arterial decline. Clearly, reducing homocysteine does not quickly repair existing structural damage of the artery architecture. However, the science is strong supporting the biochemistry that homocysteine degrades and inhibits the formation of the 3 main structural components of the artery, collagen, elastin and the proteoglycans. Homocysteine permanently degrades cysteine bridges and lysine amino acid residues in proteins, gradually affecting function and structure. Simply put, homocysteine is a 'corrosive' of long-living elastin or life-long proteins *. These long-term effects are difficult to establish in clinical trials focussing on groups with existing artery decline. The main role of reducing homocysteine is likely in 'prevention' but with a slow but probable role in 'cure'.
Vitamin supplements could counter the effects of homocysteine on collagen. As B12 is inefficiently absorbed from food by elderly persons they could gain a greater benefit from taking vitamin supplements.
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