Homocysteine

Homocysteine is biosynthesized naturally via a multi-step process. First, methionine receives an adenosine group from ATP, a reaction catalyzed by S-adenosyl-methionine synthetase, to give S-adenosyl methionine (SAM). SAM is a widely used source of methyl radicals and a cofactor for radical SAM enzymes. Transfer of the methyl group to an acceptor molecule results in the formation of S-adenosyl-homocysteine. Hydrolysis of this thioether gives L-homocysteine. L-Homocysteine reacts with tetrahydrofolate (THF) to give L-methionine. Biosynthesis of cysteine Mammals biosynthesize the amino acid cysteine via homocysteine. Cystathionine β-synthase catalyses the condensation of homocysteine and serine to give cystathionine. This reaction uses Pyridoxal phosphate (vitamin B6) as a cofactor. Cystathionine γ-lyase then converts this double amino acid to cysteine, ammonia, and α-ketobutyrate. Bacteria and plants rely on a different pathway to produce cysteine, relying on O-acetylserine. - 5-MTHF: 5-methyltetrahydrofolate; 5,10-methyltetrahydrofolate; BAX: Bcl-2-associated X protein; BHMT: betaine-homocysteine S-methyltransferase; CBS: cystathionine beta synthase; CGL: cystathionine gamma-lyase; DHF: dihydrofolate (vitamin B9); DMG: dimethylglycine; dTMP: thymidine monophosphate; dUMP: deoxyuridine monophosphate; FAD+ flavine adenine dicucleotide; FTHF: 10-formyltetrahydrofolate; MS: methionine synthase; MTHFR: mehtylenetetrahydrofolate reductase; SAH: S-adenosyl-L-homocysteine; SAME: S-adenosyl-L-methionine; THF: tetrahydrofolate Methionine salvage Homocysteine can be recycled into methionine. This process uses N5-methyl tetrahydrofolate as the methyl donor and Methylcobalamin (vitamin B12)-related enzymes. More detail on these enzymes can be found in the article for methionine synthase. Other reactions of biochemical significance Homocysteine can cyclize to give homocysteine thiolactone, a five-membered heterocycle. Because of this "self-looping" reaction, homocysteine-containing peptides tend to cleave themselves by reactions generating oxidative stress. Homocysteine also acts as an allosteric antagonist at Dopamine D2 receptors. It has been proposed that both homocysteine and its thiolactone may have played a significant role in the appearance of life on the early Earth. ==Homocysteine levels==

Homocysteine levels typically are higher in men than women, and increase with age. Common levels in Western populations are 10 to 12 μmol/L, and levels of 20 μmol/L are found in populations with low B-vitamin intakes or in the elderly (e.g., Rotterdam, Framingham). It is decreased with methyl folate trapping, where it is accompanied by decreased methylmalonic acid, increased folate, and a decrease in formiminoglutamic acid. This is the opposite of MTHFR C677T mutations, which result in an increase in homocysteine. The ranges above are provided as examples only; test results always should be interpreted using the range provided by the laboratory that produced the result. ==Elevated homocysteine==

Abnormally high levels of homocysteine in the serum, above 15 μmol/L, are a medical condition called hyperhomocysteinemia. This has been claimed to be a significant risk factor for the development of a wide range of diseases, in total more than 100 including thrombosis, neuropsychiatric illness, in particular dementia and fractures. It also is found to be associated with microalbuminuria (moderately increased albuminuria), which is a strong indicator of the risk of future cardiovascular disease and renal dysfunction. Vitamin B12 deficiency, even when coupled with high serum folate levels, has been found to increase overall homocysteine concentrations as well. Typically, hyperhomocysteinemia is managed with vitamin B6, vitamin B9, and vitamin B12 supplementation. However, supplementation with these vitamins does not appear to improve cardiovascular disease outcomes. An important consideration when specifically supplementing with folic acid (vitamin B9) is to use a lower dosage. Over-supplementation with folic acid may produce negative health effects, including increased risk of cardiovascular disease and the development of cancer. It has been shown that the ideal dose of folic acid for lowering homocysteine levels is up to 1.2 mg per day. Higher dosages do not result in a greater decrease of homocysteine levels in the general population, which excludes individuals with certain mutations in the MTHFR gene. This can be treated by supplementation with Methylfolate, P5P, and methylcobalamin, which are the bioactive forms of folate, Vitamin B6, and vitamin B12 respectively. This treatment also significantly lowers LDL cholesterol levels in patients with low to moderate cardiovascular disease risk. However, the treatment does not significantly affect HDL cholesterol levels or lipid measurements. == References ==