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Volume 346:2007-2008 June 20, 2002 Number 25
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Homocysteine and Dementia

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 by Seshadri, S.
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To the Editor: Seshadri and colleagues (Feb. 14 issue)1 report that high homocysteine levels are a risk factor for Alzheimer's disease. The effect of homocysteine on brain tissue is influenced by the absence within this tissue of two of the major metabolic routes for the elimination of homocysteine: betaine-mediated conversion and transsulfuration.2,3 Consequently, under conditions of folate deprivation, homocysteine can be eliminated only by export from the neuron. Increased export is problematic, however, as the authors point out, since homocysteine activates N-methyl-D-aspartate receptors and potentiates glutamate excitotoxicity.4 Minimizing homocysteine export may therefore be critical for nervous tissue, and it . . . [Full Text of this Article]

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