同型半胱氨酸与心脑血管疾病的关系及致病机理

Increased plasma homocysteine (Hcy) is a significant and independent risk factor for cardiovascular disease (CVD). It can cause multi-disease manifestations such as: smooth muscle proliferation, premature occlusive vascular disease, progressive arterial stenosis, haemostatic changes, placental vasculopathy, spontaneous early abortion, birth defects, impaired cognitive function and dementia. The aim of this review paper was to summarize the role of elevated Hcy levels in cardiovascular and other diseases and the molecular mechanisms and pathophysiology involved in deleterious manifestations of hyperhomocysteinemia (HHcy). We have collected data from MEDLINE, Current Contents and scientific journals, which included 131 publications from 1932 to 2007. The pathophysiology could be caused by the direct toxicity of Hcy on tissues. Mechanisms through which Hcy induces CVD include endothelial dysfunction, oxidative stress, smooth muscle cell (SMC) proliferation, enhancing thrombogenicity, formation of reactive oxygen species (ROS), hypomethylation, induction of unfolded protein response (UPR) and extracellular matrix modification. Furthermore, we enumerated some existing therapeutic approaches. However, further studies should be conducted to investigate new operative therapeutic methods of HHcy.