Sauls Derrick L, Arnold Erin K, Bell Charles W, Allen Jonathan C, Hoffman Maureane
Pathology and Lab Medicine Service, Durham Veterans Affairs Medical Center, Durham, Nutrition Program, Department Food Science, NC State University, Raleigh, NC, USA.
Thromb Res. 2007;120(1):117-26. doi: 10.1016/j.thromres.2006.08.001. Epub 2006 Sep 18.
Elevated plasma homocysteine levels are associated with the risk of atherosclerosis and arterial and venous thrombosis. We have previously demonstrated that rabbits rendered hyperhomocysteinemic by parenteral administration of homocysteine develop a dysfibrinogenemia that is associated with the formation of fibrin clots that are abnormally resistant to fibrinolysis. We suggested that this acquired dysfibrinogenemia contributes to the thrombotic tendency in hyperhomocysteinemia. However, it was possible that the homocysteine-associated dysfibrinogenemia was an artifact of the parenteral administration model. Therefore, the goals of the current study were to develop a diet-induced model of homocysteinemia in rabbits and determine whether a dysfibrinogenemia and evidence of oxidative stress develop in this model as they do when homocysteine is injected. We found that rabbits fed a diet severely deficient in folate and mildly deficient in choline develop mild hyperhomocysteinemia: 14.8+/-4.0 microM in deficient rabbits compared to 9.0+/-1.7 microM in controls. The deficient rabbits also develop evidence of oxidant stress: increased lipid peroxidation in liver, impaired mitochondrial enzyme activities in liver and elevated caspase-3 levels in plasma. Most importantly, the deficient rabbits also develop a dysfibrinogenemia characterized by increased resistance to fibrinolysis. We believe that this dietary model of homocysteinemia is clinically relevant and reproduces many features associated with hyperhomocysteinemia in previous work using in vitro and in vivo models. Our findings suggest that an acquired dysfibrinogenemia could play a role in the increased risk of atherothrombotic disease in mildly hyperhomocysteinemic human subjects.
血浆同型半胱氨酸水平升高与动脉粥样硬化、动静脉血栓形成风险相关。我们之前已证明,通过肠胃外给予同型半胱氨酸使兔子产生高同型半胱氨酸血症,会引发异常纤维蛋白原血症,这与形成对纤维蛋白溶解异常抵抗的纤维蛋白凝块有关。我们认为这种后天获得的异常纤维蛋白原血症促成了高同型半胱氨酸血症中的血栓形成倾向。然而,同型半胱氨酸相关的异常纤维蛋白原血症有可能是肠胃外给药模型造成的假象。因此,本研究的目的是建立一种饮食诱导的兔子高同型半胱氨酸血症模型,并确定该模型中是否会像注射同型半胱氨酸时那样出现异常纤维蛋白原血症和氧化应激证据。我们发现,喂食严重缺乏叶酸且轻度缺乏胆碱饮食的兔子会出现轻度高同型半胱氨酸血症:缺乏组兔子的血浆同型半胱氨酸水平为14.8±4.0微摩尔/升,而对照组为9.0±1.7微摩尔/升。缺乏组兔子还出现了氧化应激证据:肝脏中脂质过氧化增加、肝脏中线粒体酶活性受损以及血浆中半胱天冬酶-3水平升高。最重要的是,缺乏组兔子还出现了以对纤维蛋白溶解抵抗增加为特征的异常纤维蛋白原血症。我们认为这种高同型半胱氨酸血症的饮食模型具有临床相关性,并且重现了先前使用体外和体内模型研究中与高同型半胱氨酸血症相关的许多特征。我们的研究结果表明,后天获得的异常纤维蛋白原血症可能在轻度高同型半胱氨酸血症的人类受试者发生动脉粥样硬化血栓形成疾病风险增加中起作用。