title: Vascular and cellular stress in inflammatory bowel disease: revisiting the role of homocysteine.
abstract: Moderate hyperhomocysteinemia is a complex trait commonly associated with inflammatory bowel disease (IBD). Nutritional deficiencies and genetic determinants have been identified as risk factors for moderate hyperhomocysteinemia, such as folate and vitamin B(12) deprivation and polymorphisms in the 5,10 methylenetetrahydrofolate reductase (MTHFR) encoding gene, respectively. Homocysteine has a crucial role in cellular stress, epigenetic events, inflammatory processes, and host-microbial interactions. Hyperhomocysteinemia might therefore influence the clinical history of IBD, including disease severity, susceptibility to particular enteric infections, and the risk for the development of colorectal cancer. In contrast, homocysteine metabolism does not seem to contribute to the greater risk of thrombosis in IBD subjects. Herein, we review the evidence linking homocysteine metabolism to the pathophysiology of IBD. Furthermore, we discuss the relevance of screening and treating folate and vitamin B(12) deficiencies in IBD subjects. Given the peculiar frequency of such deficiencies in IBD, normalizing vitamin levels should be an integral part of the management of these patients, especially those with active disease, history of intestinal resection, and/or treated with methotrexate.
authors.affiliation: Inserm, U724, Laboratory of Cellular and Molecular Pathology in Nutrition, Faculty of Medicine, Nancy-Universitè Vandoeuvre-les-Nancy, F-54511, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Peyrin-Biroulet
authors.forename: Rosa-Maria
authors.initials: RM
authors.lastname: Rodriguez-Guéant
authors.forename: Mathias
authors.initials: M
authors.lastname: Chamaillard
authors.forename: Pierre
authors.initials: P
authors.lastname: Desreumaux
authors.forename: Bing
authors.initials: B
authors.lastname: Xia
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bronowicki
authors.forename: Marc-André
authors.initials: MA
authors.lastname: Bigard
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Guéant
mesh_terms: D000818:Animals; D005494:Folic Acid Deficiency / Q000150:complications; D006710:Homocysteine / Q000502:physiology*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications* / Q000209:etiology / Q000235:genetics; D015212:Inflammatory Bowel Diseases / Q000209:etiology*; D018384:Oxidative Stress; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology*; D014806:Vitamin B 12 Deficiency / Q000150:complications
chemical_list: D006710:Homocysteine