Cystathionine P-synthase (CBS) deficiency in humans is a rare autosomal recessive disease, which is the most common cause of homocystinuria. Individuals with this disorder have a variety of clinical phenotypes including ocular, skeletal, neurological, and cardiovascular defects, which are believed to result primarily from elevated plasma homocysteine levels. Age of onset, symptoms, and severity of the disease can vary greatly among patients (1). Some, but not all, individuals with homocystinuria respond to increased dietary levels of vitamin B6 with an increase in residual enzyme activity associated with a lowering of plasma homocysteine levels. Within sibships, almost complete concordance is observed for responsiveness and nonresponsiveness to vitamin B6 (2). Concordance within sibships is also observed in the residual CBS activity found in cultured fibroblast cells derived from affected individuals (3). Residual enzyme activity in fibroblast extracts ranges from undetectable to 10%6 of normal controls. Generally, vitamin B6 responders have higher levels of residual CBS activity than nonresponders (3-6). These observations suggest that different mutations within the CBS gene alter the enzyme activity in discrete ways; thus, different CBS mutations may be related to the clinically observed heterogeneity found in patients with CBS deficiency.A life-threatening complication of CBS deficiency is thromboembolism (1). Untreated vitamin B6 responsive and nonresponsive individuals have a 4% risk per year of a thrombolytic event (2). Thrombosis can occur at any age and can involve both large and small arteries. Studies also suggest that individuals heterozygous for mutations in CBS are at increased risk for premature peripheral and cerebral arterial disease (7-10). These studies show a correlation between reduced levels of CBS activity and premature vascular disease. Since ='1 in 200 people in the general population is a heterozygote (1), it has been suggested that these individuals may account for a large fraction of those at risk for stroke. However, testing this hypothesis is difficult due to the lack of an accurate assay that identifies heterozygotes (11).To identify and study mutations that cause homocystinuria, an effective assay for the human CBS gene product is required. Such an assay system must be able to distinguish DNA polymorphisms with no phenotypic effect from mutations that affect enzymatic function. In addition, the assay must be able to isolate individual alleles for study.We report here the development of such an experimental system for the study of human CBS using Saccharomyces cerevisiae. We (MATa ura3-52 cys4-1 cys2-1) and WC44a (MATa ura3-52) were constructed by crossing JW1-2c (MATa cys2-1 cys4-1)