Homocyst(e)ine In The Context Of Acute Cerebral Infarction: The Pathogenesis Of Oxidative Stress

Objective To study association of serum homocysteine (Hcy) concentration and the status of oxidant stress in the acute phase of cerebral infarction. To investigate the possible role of homocyst(e)ine. Methods We determined levels of serum homocyst(e)ine(Hcy) vitamin B12(VitB12) folic acid (FA) lipid peroxide (P-LPOX ascorbic acid (P-VitC) superoxide dismutase (E-SOD) and nitric oxide (P-NO) in 45 cerebral infarction group (CIG) within 3 days of the onset of the attack as well as in 30 normal control group (CG) of comparable age and gender. Result Statistically significant elevation of homocyst(e)ine nitric oxide lipid peroxide plasma levels were observed in CIG compared with CG (P<0.001). On the other hand, the antioxidant ascorbic acid superoxide dismutase folic acid vitamin B12 levels were significantly lower in CIG compared with CG (P<0.001). Highperhomocysteine was present in 18 cases in CIG(40%), while 2 cases in CG(6.7%). The relativity ratio for cerebral infarction was 5.95(95% 1.8-19.54 )for high Hcy cases with normal Hcy cases. In CIG, Hcy levels were significantly negatively correlated with both VitB12 and FA((r=-0. 47 -0. 32, P<0.01P<0.05 ) . The study also revealed a significant and positive correlation between Hcy and P-LPO level (r=0.38 PO.001) P-NO (r=0.50, P<0.001), while a significant and negative correlation between Hcy and P-VitC level (R=-0.55, P<0.001) . The P-VitC level was negatively correlated with P-LPO (R=-0.60 P<0.001). The NO level was negatively correlated with P-SOD (R=-0.83 P<0.001) . Statistically significant elevation of nitric oxide lipid peroxide plasma levels were observed in high Hcy group in CIG compared with normal Hcy group in CIG (P<0.001). On the other hand, the antloxidant ascorbic acid superoxide dismutase levels were significantly lower in high Hcy group in CIG compared with normal Hcy group in CIG (P<0.01 P<0.001). Conclusion Hyperhomocysteinmia appears to have association with increased prevalent cerebral infarction. Hyperhomocysteinmia results from the relative deficiency of vitamin B12 and folic acid. Oxidative stress plays an important role in cerebral infarction. We conclude that hyperhomocyst(e)inemia is a possible causal factor in oxidative stress during the acute phase of CI.