Serum homocysteine, folate and vitamin B<sub>12</sub>levels in patients with psoriasis: a systematic review and meta‐analysis

Tsai, Tsung Yu; Yen, Hung-Hsuan; Huang, Yu‐Chen

doi:10.1111/bjd.17034

Cited by 19 publications

(27 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Very recently, a systematic review and meta-analysis demonstrated that, compared with controls, patients with psoriasis had a significantly higher serum Hcy level and a higher prevalence of HHcy [23]. Therefore, a link between HHcy and psoriasis is established.…”

Section: Hcy Levels In Patients With Psoriasismentioning

confidence: 99%

Homocysteine and psoriasis

Lin

Meng²,

Song

2019

Bioscience Reports

View full text Add to dashboard Cite

Psoriasis is caused by a complex interplay among the immune system, genetic background, autoantigens, and environmental factors. Recent studies have demonstrated that patients with psoriasis have a significantly higher serum homocysteine (Hcy) level and a higher prevalence of hyperhomocysteinaemia (HHcy). Insufficiency of folic acid and vitamin B12 can be a cause of HHcy in psoriasis. Hcy may promote the immuno-inflammatory process in the pathogenesis of psoriasis by activating Th1 and Th17 cells and neutrophils, while suppressing regulatory T cells. Moreover, Hcy can drive the immuno-inflammatory process by enhancing the production of the pro-inflammatory cytokines in related to psoriasis. Hcy can induce nuclear factor kappa B activation, which is critical in the immunopathogenesis of psoriasis. There may be a link between the oxidative stress state in psoriasis and the effect of HHcy. Hydrogen sulfide (H2S) may play a protective role in the pathogenesis of psoriasis and the deficiency of H2S in psoriasis may be caused by HHcy. As the role of Hcy in the pathogenesis of psoriasis is most likely established, Hcy can be a potential therapeutic target for the treatment of psoriasis. Systemic folinate calcium, a folic acid derivative, and topical vitamin B12 have found to be effective in treating psoriasis.

show abstract

Section: Hcy Levels In Patients With Psoriasismentioning

confidence: 99%

Homocysteine and psoriasis

Lin

Meng²,

Song

2019

Bioscience Reports

View full text Add to dashboard Cite

show abstract

“…Even though the association between psoriasis and cardiovascular diseases is lately extensively studied, the exact underlying mechanisms have not yet been uncovered 7 . As suggested in some previously published studies, elevated serum homocysteine levels might contribute to the cardiovascular risk in psoriatic patients [8][9][10] . Homocysteine is sulfur containing amino acid, displaying atherogenic and prothrombotic features.…”

mentioning

confidence: 65%

“…A meta-analysis of 24 studies showed that psoriatic patients have higher homocysteine serum levels, a greater prevalence of hyperhomocysteinemia and, conversely, have lower serum folate levels compared to controls. Yet, the two groups did not signi cantly di er in vitamin B12 serum levels 10 . Rapid keratinocyte proliferation with high mitotic activity of basal cells, along with intestinal malabsorption caused by microscopic in ammatory changes of the intestinal mucosa, might contribute to folate de ciency in patients with psoriasis.…”

mentioning

confidence: 78%

Serum levels of homocysteine in young psoriasis patients naïve for conventional systemic and biologic therapy

Levak¹,

Plužarić²,

Krajina³

et al. 2020

Rad Hrvatske akademije znanosti i umjetnosti

View full text Add to dashboard Cite

Introduction: Psoriasis is an immune-mediated chronic in ammatory disease, a ecting approximately 1-3% of the population worldwide. Psoriasis patients are more likely to be diagnosed with cardiovascular diseases and hyperhomocysteinemia; however, it remains elusive weather serum homocysteine levels correlate to disease activity and duration of disease. e aim of this study was to investigate serum levels of homocysteine in young patients with plaque psoriasis naïve for conventional systemic and biologic therapy. An additional aim was to determine correlation of homocysteine levels with disease severity, in ammation, folic acid and vitamin B12 supplies. Materials and methods: 26 subjects were enrolled to participate in this case-control study, including 13 adult psoriatic patients naïve for systemic therapy, without comorbidities, malignancies and infectious diseases, and 13 healthy unrelated, age and sex-matched volunteers. e disease severity and life quality were assessed using standardized tools -Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI), respectively. Venous blood was collected and processed for analysis of di erential blood count (DBC), erythrocyte sedimentation rate (ESR), C reactive protein (hsCRP), serum levels of homocysteine, vitamin B12 and folic acid in the routine clinical laboratory. Results Studied cohort consisted of young participants with average age around 35 years. According to the PASI index, disease severity ranged from mild (2.10) to moderate (15.2). ere was no signi cant di erence in hsCRP and DBC levels between the groups. Psoriasis patients had signi cantly higher levels of homocysteine compared to healthy subjects, but there was no evidence of hyperhomocysteinemia related to psoriasis. All subjects had normal serum levels of vitamin B12 and folic acid. A moderate negative correlation was found between plasma homocysteine level and vitamin B12 and folic acid. Furthermore, homocysteine levels did not correlate to hsCRP, total leukocytes, and thrombocytes count, but did signi cantly positively correlate to ESR. Conclusions: e risk of cardiovascular diseases should be considered among all psoriasis patients, regardless of age and disease severity, but larger prospective controlled studies are needed to estimate the role of homocysteine in cardiovascular morbidity and mortality in psoriatic patients. psoriasis, homocysteine, folic acid, cardiovascular disease

show abstract

“…Homocysteine might be involved in the pathogenesis of psoriasis [24]. Almost half of our patients suffered from hyperhomocysteinemia, which positively correlated with increasing numbers of micronucleated cells.…”

Section: Discussionmentioning

confidence: 99%

Goeckerman Therapy of Psoriasis: Genotoxicity, Dietary Micronutrients, Homocysteine, and MTHFR Gene Polymorphisms

Beránek

Málková

Fiala

et al. 2019

IJMS

View full text Add to dashboard Cite

Goeckerman therapy (GT) of psoriasis vulgaris is based on the application of crude coal tar and ultraviolet radiation. We investigated DNA damage by the number of micronucleated binucleated cells (MNBC) in lymphocytes, serum homocysteine, vitamin B12, folic acid, and two polymorphisms (C677T and A1298C) in the MTHFR gene in 35 patients with exacerbated psoriasis vulgaris classified according to the psoriasis area and severity index (PASI) score and treated by GT. The median of PASI score decreased from nineteen to five, and MNBC increased from 10 to 18‰ after GT (p < 0.001 in both cases). Correlations of MNBC with homocysteine (Spearman’s rho = 0.420, p = 0.012) and vitamin B12 (rho = −0.389, p = 0.021) before the therapy were observed. Hyperhomocysteinemia was an independent predictor of genotoxicity (OR 9.91; 95% CI, 2.09–55.67; p = 0.003). Homocysteine was higher in females than in males (13 vs. 12 µmol/L, p = 0.045). In contrast, vitamin B12 levels in the females were lower than in the males (160 vs. 192 pmol/L, p = 0.047). Vitamin B12 in the females were negatively influenced by smoking status (160 pmol/L in smokers vs. 192 pmol/L in non-smokers, p = 0.025). A significantly higher MNBC was found in CC homozygous patients (A1298C polymorphism) than in AC heterozygotes (32 vs. 16‰, p = 0.005) and AA homozygotes (32 vs. 18‰, p = 0.036). Our data showed that homocysteine participates in the pathogenesis of psoriasis. Its serum levels correlated with MNBC and allowed the prediction of DNA damage to appear within GT. Both micronutrients status and homocysteine metabolic pathway contribute to the genotoxicity of GT.

show abstract

Serum homocysteine, folate and vitamin B₁₂levels in patients with psoriasis: a systematic review and meta‐analysis

Abstract: Patients with psoriasis might have higher serum homocysteine and lower folate levels than control patients without psoriasis. However, due to significant heterogeneity and other limitations, the associations require further examinations in more studies.

Cited by 19 publications

References 49 publications

Homocysteine and psoriasis

Homocysteine and psoriasis

Serum levels of homocysteine in young psoriasis patients naïve for conventional systemic and biologic therapy

Goeckerman Therapy of Psoriasis: Genotoxicity, Dietary Micronutrients, Homocysteine, and MTHFR Gene Polymorphisms

Contact Info

Product

Resources

About

Serum homocysteine, folate and vitamin B12levels in patients with psoriasis: a systematic review and meta‐analysis

Abstract: Patients with psoriasis might have higher serum homocysteine and lower folate levels than control patients without psoriasis. However, due to significant heterogeneity and other limitations, the associations require further examinations in more studies.

Cited by 19 publications

References 49 publications

Homocysteine and psoriasis

Homocysteine and psoriasis

Serum levels of homocysteine in young psoriasis patients naïve for conventional systemic and biologic therapy

Goeckerman Therapy of Psoriasis: Genotoxicity, Dietary Micronutrients, Homocysteine, and MTHFR Gene Polymorphisms

Contact Info

Product

Resources

About

Serum homocysteine, folate and vitamin B₁₂levels in patients with psoriasis: a systematic review and meta‐analysis