Homocysteine

Homocysteine is formed in the body during the metabolism of the amino acid methionine. In plasma, the substance is predominantly found in a protein-bound form. In disorders of homocysteine metabolism due to genetic or functional enzyme defects, or vitamin deficiency, homocysteine accumulates inside cells in increased amounts and enters the extracellular space, and then into the plasma. Elevated homocysteine concentrations are cytotoxic. Homocysteine can damage the vascular endothelium, which promotes the progression of atherosclerosis. Increased blood homocysteine content enhances thrombus formation. During pregnancy, elevated homocysteine levels can cause complications such as spontaneous abortions, preeclampsia and eclampsia, and thromboembolism. The following factors influence the increase in plasma homocysteine levels: intake of penicillamine, cyclosporine, methotrexate, carbamazepine, phenytoin, 6-azauridine; diseases such as hypothyroidism, renal failure; as well as smoking excesses, alcohol consumption, and large amounts of coffee. Hereditary diseases may also be accompanied by some increase in total blood homocysteine content. Determination of homocysteine in blood plasma is mainly used to assess the risk of developing cardiovascular diseases.

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