Asthmatic Patients: Is Homocysteine an Issue?

Abstract

Objective: Understanding the causes of asthma is crucial for developing new therapeutic modalities. Homocysteine (HCY) is an intermediate in methionine metabolism. Elevated HCY levels may indicate folate and vitamin B12 deficiencies, which are cofactors for the methylation of HCY to methionine. The relationship between hyperHCY mia and atherosclerosis is well-documented, and it is considered a cause of cardiovascular, neurodegenerative, and ocular diseases. HyperHCY mia may also cause atopy and, consequently, asthma. We aimed to evaluate the levels of HCY, vitamin B12, and folic acid in asthmatic patients and healthy adults, as well as to determine whether correlations exist between these levels and lung function, eosinophil counts, total immunoglobulin E (IgE), and eosinophilic cationic protein (ECP) levels in asthmatic subjects. Methods: A total of 142 asthmatic patients and 36 healthy controls were enrolled in the study. Folic acid, vitamin B12, total IgE, ECP, eosinophil percentage, eosinophil counts, and HCY levels were evaluated in both groups. Results: HCY, vitamin B12, and folic acid levels did not significantly differ between patients with asthma and controls. There was a statistically significant positive correlation (at the 0.95 confidence level) between HCY values and forced vital capacity, peak expiratory flow (PEF), and eosinophil counts in patients with asthma. Folic acid levels correlated positively only with PEF%, whereas vitamin B12 levels did not correlate with any functional parameters or atopic markers like IgE and ECP. Conclusion: Should large-scale randomized controlled trials conclusively establish HCY as a causative factor of asthma, metabolic interventions to lower HCY levels using methyl donors could be considered alongside conventional asthma treatments.