Department of Ophthalmology, West China Hospital, Sichuan University, 610041, Chengdu, China.
Research Laboratory of Macular Disease, West China Hospital, Sichuan University, 610041, Chengdu, China.
BMC Ophthalmol. 2023 Oct 13;23(1):413. doi: 10.1186/s12886-023-03149-z.
Folate, a pteroylglutamic acid derivative, participates in fundamental cellular metabolism. Homocysteine, an amino acid, serves as an intermediate of the methionine cycle and can be converted back to methionine. Hyperhomocysteinemia is a recognized risk factor for atherosclerotic and cardiovascular diseases. In recent decades, elevated plasma homocysteine levels and low folate status have been observed in many patients with retinal vascular diseases, such as retinal vascular occlusions, diabetic retinopathy, and age-related degeneration. Homocysteine-induced toxicity toward vascular endothelial cells might participate in the formation of retinal vascular diseases. Folate is an important dietary determinant of homocysteine. Folate deficiency is the most common cause of hyperhomocysteinemia. Folate supplementation can eliminate excess homocysteine in plasma. In in vitro experiments, folic acid had a protective effect on vascular endothelial cells against high glucose. Many studies have explored the relationship between folate and various retinal vascular diseases. This review summarizes the most important findings that lead to the conclusion that folic acid supplementation might be a protective treatment in patients with retinal vascular diseases with high homocysteine or glucose status. More research is still needed to validate the effect of folate and its supplementation in retinal vascular diseases.
叶酸是一种蝶酰谷氨酸衍生物，参与基本的细胞代谢。同型半胱氨酸是一种氨基酸，作为蛋氨酸循环的中间产物，可以转化回蛋氨酸。高同型半胱氨酸血症是动脉粥样硬化和心血管疾病的公认危险因素。近几十年来，许多视网膜血管疾病患者（如视网膜血管阻塞、糖尿病性视网膜病变和年龄相关性退行性变）的血浆同型半胱氨酸水平升高和叶酸水平降低。同型半胱氨酸对血管内皮细胞的毒性作用可能参与了视网膜血管疾病的形成。叶酸是同型半胱氨酸的重要膳食决定因素。叶酸缺乏是高同型半胱氨酸血症的最常见原因。叶酸补充可以消除血浆中多余的同型半胱氨酸。在体外实验中，叶酸对血管内皮细胞具有保护作用，可抵抗高葡萄糖。许多研究探讨了叶酸与各种视网膜血管疾病之间的关系。本综述总结了最重要的发现，这些发现得出结论，即叶酸补充可能是高同型半胱氨酸或高葡萄糖状态下视网膜血管疾病患者的一种保护治疗方法。仍需要更多的研究来验证叶酸及其补充剂在视网膜血管疾病中的作用。
