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2019 Oct 25
Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Plasma Homocysteine Level Is Associated with the Expanded Disability Status Scale in Neuromyelitis Optica Spectrum Disorder
https://www.ncbi.nlm.nih.gov/pubmed/31655825

Abstract
BACKGROUND AND OBJECTIVE:
Plasma homocysteine (Hcy) levels have been investigated among patients with multiple sclerosis (MS). However, the changes in Hcy levels and the association between Hcy levels and inflammatory/immune/cerebrospinal fluid (CSF) parameters in neuromyelitis optica spectrum disorder (NMOSD) patients have not been investigated yet.
METHODS:
Case data were collected from 97 acute-phase NMOSD patients and 39 stable-phase NMOSD patients. Patients in the acute phase were divided into 2 groups based on the EDSS score with cutoff equal to 4. Hcy levels, immunoglobulins (Ig) A, G, and M, complement 3 and 4, CH50, C-reactive protein, erythrocyte sedimentation rate (ESR), and CSF examination including white blood cells and total protein were determined.
RESULTS:
No significant differences in Hcy levels are observed between acute-phase and stable-phase NMOSD patients. Hcy and ESR levels were significantly higher in acute-phase NMOSD patients with EDSS score ≥4. Besides, EDSS is positively correlated with Hcy level, ESR, 1/aquaporin-4 titer and Hcy level is negatively correlated with IgM in acute-phase NMOSD patients.
CONCLUSION:
Elevated plasma Hcy has the potential to affect the pathogenesis or progression of NMOSD.

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2019 Jan
The Effect of Vitamin B12 and Folic Acid Supplementation on Serum Homocysteine, Anemia Status and Quality of Life of Patients with Multiple Sclerosis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355946/

..DISCUSSION
The effect of debilitating chronic diseases such as MS and their attendant problems, including the impact of disability on quality of life in all dimensions is obvious [22]. Increasing the consumption of folic acid and vitamin B12 improved physical and mental dimensions of quality of life which is in line with the findings of our study [23]. Zhang et al. [24] have shown that vitamin B12 can reduce pain in some neurological diseases such as MS. This effect was also seen in the vitamin group of the present study. Pietro et al. [23] studied on 2 groups of patients with MS and reported that the group of subjects who consumed more than 4.2 µg of vitamin B12 on daily bases had a greater improvement in the quality of life compared to the group that consumed less than 4.2 µg of this vitamin per day. The results of the present study indicated that vitamin B12 and folic acid consumption significantly improved both physical and mental dimensions of life quality in the vitamin group; but in the placebo group, improvements were only limited to the psychological dimension of quality of life and no significant change in the physical dimension was observed. ..

2020 Mar 5
Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
Serum levels of Homocysteine, Vitamin B12 and Folate in Patients with Multiple Sclerosis: an Updated Meta-Analysis.
https://www.ncbi.nlm.nih.gov/pubmed/32218697

Abstract

Background: Multiple sclerosis (MS) is a demyelinating and disabling inflammatory disease of the central nervous system. MS is triggered by complex environmental factors which mostly affect genetically the susceptible young people. Emerging data has suggested that changes of homocysteine (Hcy), Vitamin B12 and folate serum levels may be associated with MS. However, previous findings are not always consistent. Methods: In this study, we aimed to investigate the relationships between MS and Hcy, Vitamin B12 and folate with updated available data (until September, 2019). The diagnosis of MS was performed based on international criteria for the diagnosis of MS, including magnetic resonance imaging and cerebrospinal fluid tests. We searched the databases including PubMed, EMBASE, Cochrane Library and ScienceDirect. After data collection, separate analyses based on random-effect models were used to test for relationships between MS and Hcy, Vitamin B12 or folate blood levels. The effective sizes were estimated by the combined standardized mean difference (SMD) and associated 95% confidence interval (CI). Results: Based on the inclusion criteria, a total of 21 original studies with 1738 MS patients and 1424 controls were included in this study. There were 17 studies for measuring Hcy, 16 studies for measuring Vitamin B12 and 13 studies for measuring folate in patients with MS, respectively. Specifically, patients with MS had higher serum levels of Hcy (SMD: 0.64; 95% CI:0.33, 0.95; P <0.0001) compared with control groups. There were no significant differences of SMD for Vitamin B12 (SMD: -0.08; 95% CI: -0.35, 0.20; P=0.58) or folate (SMD: 0.07; 95% CI: -0.14, 0.28; P=0.52) between MS and controls. Subgroup analysis demonstrated that there was statistically significant difference for Hcy between relapsing-remitting MS (RRMS) patients and controls with a SMD of 0.67 (95% CI: 0.21, 1.13; P=0.004). However, no significant difference of Hcy serum levels between secondary progressive MS patients or primary progressive MS patients and controls was noted in this study. In addition, there was no significant difference of Hcy levels in females (SMD: 0.22; 95% CI: -0.16, 0.60; P=0.25) or males (SMD: 0.56; 95% CI: -0.13, 1.26; P=0.11) between MS patients and controls. Conclusions: Higher serum levels of Hcy were noted in patients with MS when compared with control groups. And the difference was especially significant between RRMS patients and controls. Hcy may play an important role in the pathogenesis of MS. Functional studies are required to assess the effects of Hcy on patients with MS at the molecular level.

PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085269/

2020 Mar 14
Department of Neurology of Lublin Medical University, Lublin, Poland
Cladribine Treatment Improved Homocysteine Metabolism and Increased Total Serum Antioxidant Activity in Secondary Progressive Multiple Sclerosis Patients.
https://www.ncbi.nlm.nih.gov/pubmed/32256946

Abstract

Hyperhomocysteinemia plays a crucial role in the pathogenesis of many diseases of the central nervous system (CNS). The nervous system is particularly sensitive to high homocysteine (Hcy) level mainly due to its prooxidative and cytotoxic effects. Cladribine, a drug recently registered for the treatment of multiple sclerosis (MS), possesses additionally neuroprotective effects which are independent of its peripheral immunosuppressant action. Accumulating evidence suggests that oxidative stress and homocysteine thiolactone-mediated protein homocysteinylation play a causal role in MS. Both of these processes may be attenuated by paraoxonase 1 (PON1). Therefore, in the present study, we aimed to examine whether the beneficial effects of the drug in MS patients with a secondary progressive (SP) clinical course, treated with cladribine subcutaneously (s.c.), may be related to its ability to modify serum PON1 activity, Hcy concentration, and protein homocysteinylation, as well as to correct total antioxidant status. A total of 118 subjects were enrolled into the study: (1) patients with a SP type of MS, SP-MS (n = 40); (2) patients with a relapsing-remitting (RR) type of MS, RR-MS (n = 30); and (3) healthy people (n = 48). Patients with SP-MS were treated with cladribine. The drug was given in SP-SM patients s.c. six times every 6 weeks up to a total mean cumulative dose of 1.8 mg/kg. PON1 activity was assessed spectrophotometrically. The level of Hcy, homocysteine thiolactone (HTL) attached to plasma proteins (N-Hcy-protein), and antibodies against homocysteinylated proteins was assessed with an enzyme immunoassay. The total antioxidant activity of the serum was assessed with the ferric-reducing activity of plasma (FRAP) method. Basically, there was no difference in PON1 activity between untreated SP-MS, RR-MS, and control subjects. Serum Hcy was significantly higher in RR-MS patients (p < 0.001) and in SP-MS patients (p < 0.01) compared to the control group. The N-Hcy protein level was higher in RR-MS patients (p < 0.05) in comparison to the control group. Moreover, the elevated level of antibodies against homocysteinylated proteins was observed in the serum of patients with SP-MS. The total antioxidant capacity of serum was lower in MS patients vs. the control group (p < 0.001). After cladribine treatment, the activity of PON1 did not change in SP-MS patients, whereas cladribine treatment decreased the level of total Hcy (p < 0.05). Treatment with cladribine increased the total serum antioxidant activity in SP-MS patients (p < 0.01). The Expanded Disability Status Scale (EDSS) score did not change in SP-MS patients. Cladribine treatment in the SP-MS group attenuates hyperhomocysteinemia-induced protein homocysteinylation (n.s.). It also stabilises the neurological condition of SP-MS patients. The stabilisation of a neurological condition observed in SP-MS patients after cladribine treatment may be partially related to its ability to reduce elevated Hcy level and to improve serum antioxidant potential.

These three items can each lower homocysteine.

Vitamin B12 (methylcobalamin)
Vitamin B9 (methylfolate)
Vitamin B6 (pyridoxal-5'-phosphate)

You can get them all together in one small sublingual tablet.

Superior Source Activated B12

For more info on homocysteine see the discussion in the following topic.

viewtopic.php?f=27&t=24857

2020 Aug
Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, China
Ambient Air Pollution and Homocysteine: Current Epidemiological Evidence and a Call for Further Research
https://pubmed.ncbi.nlm.nih.gov/32454311/

Abstract

Elevated blood homocysteine (Hcy) is an independent risk factor for cardiovascular disease. A growing number of studies have evaluated the link between air pollution and blood Hcy levels, but the results are inconsistent. To date, no systematic review of the published studies has been conducted yet. We aimed to provide a comprehensive overview of these studies. We systematically searched three international databases (PubMed, Web of Science, and Embase) and four Chinese databases (Wanfang, CNKI, CBM, and VIP) for peer-reviewed epidemiological studies investigating associations between ambient air pollutants and Hcy levels published before December 2019. We screened literature, extracted data, assessed methodological quality, and evaluated the risk of bias of the included studies. Of 1157 identified articles, 10 were finally included in this systematic review. Most were cross-sectional studies and were performed in developed countries. Particulate matter with aerodynamic diameters less than 2.5 μm (PM2.5) and/or 10 μm (PM10) were investigated in all of the included studies. Overall, the evidence generally supports a positive association between higher PM concentrations and elevated Hcy levels. However, high heterogeneity in terms of study participants, study design, exposure duration, and particle components and sources, low methodological quality and probable high risk of bias in some studies, and limited literature number precluded us from drawing a robust conclusion. Associations between Hcy and gaseous pollutants were explored in only one or two studies, and the results were inconclusive. Additional, well-designed studies remain required to validate the association between air pollution and Hcy.

2021 Apr 21
Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China; Beijing Centre for Disease Prevention and Control, China
Associations of long-term exposure to air pollution with blood pressure and homocysteine among adults in Beijing, China: A cross-sectional study
https://pubmed.ncbi.nlm.nih.gov/33894236/

Abstract

Background: Studies on the hypertensive effect of long-term exposure to air pollution are mixed, and sparse evidence exists regarding its effects on homocysteine (Hcy), another crucial risk factor for cardiovascular disease (CVD).

Methods: We collected data from 23,570 participants aged 18-74 years at baseline (years 2017-2018) from a community-based cohort in China. A linear combination of concentrations from monitoring stations at the participants' home and work addresses, weighted by the time, was used to estimate two-year exposures to particulate matter with fine particles ≤2.5 μm (PM2.5), aerodynamic diameter ≤10 μm (PM10), nitrogen dioxide (NO2) and sulfur dioxide (SO2). Generalized linear regressions and logistic regressions were conducted to examine the associations between air pollution and systolic blood pressure (SBP), diastolic blood pressure (DBP), Hcy, hypertension and co-occurrence of hypertension and hyperhomocysteinemia (HHcy).

Results: The results showed that each interquartile range (IQR) increase in PM2.5 (16.1 μg/m3), PM10 (19.3 μg/m3) and SO2 (3.9 μg/m3) was significantly associated with SBP (changes: 0.64-1.86 mmHg), DBP (changes: 0.35-0.70 mmHg) and Hcy (changes: 0.77-1.04 μmol/L) in the fully adjusted model. These air pollutants were also statistically associated with the prevalence of co-occurrence of hypertension and HHcy (ORs: 1.22-1.32), which were stronger than associations with the prevalence of hypertension (ORs: 1.09-1.19). The hypertensive effects of exposure to PM2.5, PM10 and SO2 were more pronounced among elder participants, obese participants, those with established CVD or a high 10-year CVD risk and those with a family history of hypertension. However, interaction analyses of Hcy showed different patterns. Additionally, moderate level of physical activity and active travel mode benefited individuals in resisting the health impacts of air pollution on both blood pressure (BP) and Hcy.

Conclusions: Our study supports a positive relationship between air pollution and BP and Hcy among adults in Beijing, and close attention to vulnerable populations and healthy lifestyles could effectively benefit further cardiovascular health.