Homocysteine Plasmatic Concentration in Brain-Injured Neurocritical Care Patients: Systematic Review of Clinical Evidence.
cerebrovascular disease
homocysteine
perioperative care
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
13 Jan 2022
13 Jan 2022
Historique:
received:
24
11
2021
revised:
13
12
2021
accepted:
05
01
2022
entrez:
21
1
2022
pubmed:
22
1
2022
medline:
22
1
2022
Statut:
epublish
Résumé
Hyperhomocysteinemia (HHcy) is considered as an independent risk factor for several diseases, such as cardiovascular, neurological and autoimmune conditions. Atherothrombotic events, as a result of endothelial dysfunction and increased inflammation, are the main mechanisms involved in vascular damage. This review article reports clinical evidence on the relationship between the concentration of plasmatic homocysteine (Hcy) and acute brain injury (ABI) in neurocritical care patients. a systematic search of articles in the PubMed and EMBASE databases was conducted, of which only complete studies, published in English in peer-reviewed journals, were included. A total of 33 articles, which can be divided into the following 3 subchapters, are present: homocysteine and acute ischemic stroke (AIS); homocysteine and traumatic brain injury (TBI); homocysteine and intracranial hemorrhage (ICH)/subarachnoid hemorrhage (SAH). This confirms that HHcy is an independent risk factor for ABI and a marker of poor prognosis in the case of stroke, ICH, SAH and TBI. Several studies elucidate that Hcy levels influence the patient's prognosis in ABI and, in some cases, the risk of recurrence. Hcy appears as biochemical marker that can be used by neuro-intensivists as an indicator for risk stratification. Moreover, a nutraceutical approach, including folic acid, the vitamins B6 and B12, reduces the risk of thrombosis, cardiovascular and neurological dysfunction in patients with severe HHcy that were admitted for neurocritical care.
Sections du résumé
BACKGROUND
BACKGROUND
Hyperhomocysteinemia (HHcy) is considered as an independent risk factor for several diseases, such as cardiovascular, neurological and autoimmune conditions. Atherothrombotic events, as a result of endothelial dysfunction and increased inflammation, are the main mechanisms involved in vascular damage. This review article reports clinical evidence on the relationship between the concentration of plasmatic homocysteine (Hcy) and acute brain injury (ABI) in neurocritical care patients.
MATERIALS AND METHODS
METHODS
a systematic search of articles in the PubMed and EMBASE databases was conducted, of which only complete studies, published in English in peer-reviewed journals, were included.
RESULTS
RESULTS
A total of 33 articles, which can be divided into the following 3 subchapters, are present: homocysteine and acute ischemic stroke (AIS); homocysteine and traumatic brain injury (TBI); homocysteine and intracranial hemorrhage (ICH)/subarachnoid hemorrhage (SAH). This confirms that HHcy is an independent risk factor for ABI and a marker of poor prognosis in the case of stroke, ICH, SAH and TBI.
CONCLUSIONS
CONCLUSIONS
Several studies elucidate that Hcy levels influence the patient's prognosis in ABI and, in some cases, the risk of recurrence. Hcy appears as biochemical marker that can be used by neuro-intensivists as an indicator for risk stratification. Moreover, a nutraceutical approach, including folic acid, the vitamins B6 and B12, reduces the risk of thrombosis, cardiovascular and neurological dysfunction in patients with severe HHcy that were admitted for neurocritical care.
Identifiants
pubmed: 35054087
pii: jcm11020394
doi: 10.3390/jcm11020394
pmc: PMC8780007
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Références
Mol Neurobiol. 2017 Apr;54(3):2022-2030
pubmed: 26910818
Clin Appl Thromb Hemost. 2011 Oct;17(5):487-93
pubmed: 20699251
Metab Brain Dis. 2018 Oct;33(5):1617-1624
pubmed: 29926428
Med Sci Monit. 2001 Jul-Aug;7(4):585-91
pubmed: 11433181
J Neurotrauma. 2011 Sep;28(9):1739-45
pubmed: 21787169
J Neurosurg. 2018 Jun;128(6):1771-1777
pubmed: 28777022
Res Synth Methods. 2021 Jan;12(1):55-61
pubmed: 32336025
Lancet Neurol. 2012 Jun;11(6):512-20
pubmed: 22554931
Stroke. 2015 Sep;46(9):2419-25
pubmed: 26199315
Arterioscler Thromb Vasc Biol. 2002 Jan;22(1):28-33
pubmed: 11788457
Brain Behav. 2016 Apr 05;6(5):e00460
pubmed: 27096104
J Neurol Sci. 2012 Jan 15;312(1-2):26-30
pubmed: 21917271
World Neurosurg. 2016 Mar;87:507-15
pubmed: 26386458
Atherosclerosis. 2019 Aug;287:30-37
pubmed: 31185379
Front Biosci (Schol Ed). 2010 Jan 01;2:359-72
pubmed: 20036953
N Engl J Med. 1997 Nov 27;337(22):1632-3
pubmed: 9411228
PLoS One. 2015 Dec 07;10(12):e0144431
pubmed: 26641086
Circulation. 2001 Jun 5;103(22):2717-23
pubmed: 11390343
BMJ. 2021 Mar 29;372:n71
pubmed: 33782057
Vascul Pharmacol. 2016 Mar;78:1-9
pubmed: 26111718
Br J Nutr. 2018 Nov;120(10):1122-1130
pubmed: 30401001
World Neurosurg. 2017 Jan;97:70-79
pubmed: 27693818
PLoS One. 2010 Sep 08;5(9):e12244
pubmed: 20838622
Trends Pharmacol Sci. 2008 May;29(5):268-75
pubmed: 18384889
Clin Chim Acta. 2018 Apr;479:132-137
pubmed: 29325799
Neurology. 2017 Nov 14;89(20):2101-2107
pubmed: 29030456
Arterioscler Thromb Vasc Biol. 2020 Mar;40(3):839-846
pubmed: 31941381
J Stroke Cerebrovasc Dis. 2015 Apr;24(4):784-8
pubmed: 25620712
Semin Vasc Med. 2005 May;5(2):77-86
pubmed: 16047261
Eur Rev Med Pharmacol Sci. 2017 May;21(10):2538-2544
pubmed: 28617530
Annu Rev Nutr. 1992;12:279-98
pubmed: 1503807
Front Nutr. 2019 Apr 24;6:49
pubmed: 31069230
Med Sci Monit. 2019 Jan 08;25:240-247
pubmed: 30617247
BMC Neurosci. 2008 Jul 07;9:62
pubmed: 18606001
Cureus. 2018 Oct 31;10(10):e3529
pubmed: 30613458
Stroke. 2017 May;48(5):1183-1190
pubmed: 28360116
Stroke. 2014 Mar;45(3):871-3
pubmed: 24448992