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IBD Patients May Benefit From Folic Acid Supplementation
      05/22/05 07:02 PM
HeatherAdministrator

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IBD Patients May Benefit From Folic Acid Supplementation

NEW YORK (Reuters Health) Apr 29 - Homocysteine levels are increased in both the mucosa and blood of patients with Crohn's disease and ulcerative colitis, according to a new study, suggesting that this molecule may play a pathogenic role in intestinal inflammation. Further, the effect could be abolished by folate supplementation.

Elevated homocysteine "contributes to the pathophysiology" of several chronic inflammatory diseases, investigators note in the April issue of the American Journal of Gastroenterology. But whether homocysteine is involved in mucosal inflammation in patients with inflammatory bowel disease (IBD) has not been explored, until now.

In their study of 83 patients with Crohn's, 83 with ulcerative colitis, and 70 healthy controls, plasma and mucosal homocysteine levels were significantly higher in IBD patients relative to control subjects.

Specifically, they observed that IBD-derived intestinal lamina propria mononuclear cells (LPMC) released higher homocysteine than control-derived LPMC.

Culturing intestinal microvascular endothelial cells in homocysteine alone, or in combination with TNF-alpha to mimic the in vivo IBD intestinal conditions, effectively triggered an inflammatory reaction in these cells, leading to upregulation of various endothelial cell adhesion molecules.

The team also observed low folate levels in the IBD patients. Folate levels were inversely correlated with homocysteine levels and, in in vitro studies, the addition of folic acid, a homocysteine scavenger, blocked the homocysteine-triggered inflammatory effects.

Therefore, Dr. Silvio Danese, from Catholic University in Rome, Italy and colleagues think it would be "reasonable to hypothesize a beneficial effect of folic acid supplementation in IBD patents to eliminate the homocysteine-mediated inflammatory events, especially mononuclear cell adhesion."

Am J Gastroenterol 2005;100:896-895.:


http://www.medscape.com/viewarticle/504063?src=mp

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