Department of Internal Medicine, Rehabilitation and Physical Medicine, Medical University of Lodz, 90-645 Lodz, Poland.
Cardiology Outpatient Clinic, Military Medical Academy Memorial Teaching Hospital of the Medical University of Lodz-Central Veterans' Hospital, 90-549 Lodz, Poland.
Int J Mol Sci. 2024 Jun 25;25(13):6924. doi: 10.3390/ijms25136924.
Methylation is a biochemical process involving the addition of a methyl group (-CH) to various chemical compounds. It plays a crucial role in maintaining the homeostasis of the endothelium, which lines the interior surface of blood vessels, and has been linked, among other conditions, to coronary artery disease (CAD). Despite significant progress in CAD diagnosis and treatment, intensive research continues into genotypic and phenotypic CAD biomarkers. This review explores the significance of the methylation pathway and folate metabolism in CAD pathogenesis, with a focus on endothelial dysfunction resulting from deficiency in the active form of folate (5-MTHF). We discuss emerging areas of research into CAD biomarkers and factors influencing the methylation process. By highlighting genetically determined methylation disorders, particularly the polymorphism, we propose the potential use of the active form of folate (5-MTHF) as a novel CAD biomarker and personalized pharmaceutical for selected patient groups. Our aim is to improve the identification of individuals at high risk of CAD and enhance their prognosis.
甲基化是一种生化过程，涉及向各种化学化合物添加一个甲基基团（-CH）。它在维持内皮细胞的内稳态中起着至关重要的作用，内皮细胞排列在血管的内表面，与冠状动脉疾病（CAD）等多种情况有关。尽管 CAD 的诊断和治疗取得了重大进展，但人们仍在继续深入研究基因型和表型 CAD 生物标志物。本综述探讨了甲基化途径和叶酸代谢在 CAD 发病机制中的意义，重点讨论了由于叶酸活性形式（5-MTHF）缺乏导致的内皮功能障碍。我们讨论了 CAD 生物标志物和影响甲基化过程的因素的新兴研究领域。通过强调遗传决定的甲基化障碍，特别是 多态性，我们提出将叶酸的活性形式（5-MTHF）用作一种新型 CAD 生物标志物和针对特定患者群体的个性化药物的可能性。我们的目标是提高对 CAD 高危人群的识别能力，并改善其预后。
