Abstract
Publisher Summary This chapter summarizes the current state of knowledge of vitamins and homocysteine metabolism. The molecular details of the role of these vitamins in the enzyme chemistry of homocysteine metabolism are discussed. Homocysteine is a sulfhydryl-containing amino acid produced from dietary methionine. Homocysteine is a thiol-containing intermediary metabolite that lies at a crossroads of three important metabolic processes: the methionine cycle, the folate cycle, and the transsulfuration pathway. Three vitamins—pyridoxine, cobalamin, and folate—play a key role in the metabolic processes which control homocysteine metabolism. Shortages in any one can result in elevated plasma homocysteine levels, which in turn cause increased risk of vascular disease and neural tube defects. The clinical potential of vitamin therapy in reducing homocysteine related diseases are also reviewed. The biochemical role for each of these vitamins in homocysteine metabolism is reviewed. The clinical and epidemiologic data concerning the role of these vitamins and homocysteine in the development of vascular disease and birth defects are described.
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