卒中、类风湿关节炎与同型半胱氨酸的关联因素

自从人们认识到同型半胱氨酸水平升高可独立引起动脉粥样硬化性血栓形成及血管内皮损伤并将其命名为高同型半胱氨酸血症,它一直都是研究的热点.不仅如此,同型半胱氨酸和类风湿关节炎的关系也尤为密切.同型半胱氨酸可以引起血管损伤并改变一些特定蛋白质的结构,造成新的可能会引起自身免疫反应的抗原的产生,因而同型半胱氨酸有可能是引起一些自身免疫疾病如类风湿关节炎的启动因素.这提示同型半胱氨酸和一些自身免疫疾病的相关性.同型半胱氨酸可以通过免疫-炎症作用引起心脑血管的损害.而免疫-炎症反应可能会增加同型半胱氨酸的水平,并损害特定的组织（心血管疾病中的血管内皮损伤、类风湿关节炎的滑膜损伤）.同型半胱氨酸和自身免疫疾病（免疫炎症反应）之间存在这样的双向作用.在本综述中,将阐述同型半胱氨酸作为卒中和类风湿关节炎之间的关联因素的合理解释,认为同型半胱氨酸是引起卒中和类风湿关节炎的因素之一,可以对这一点进行干预从而防控这两种不同的疾病.

The associated factor between rheumatoid arthritis,stroke and homocysteine

Ever since increase in homocyseteine （HCY） level termed as hyperhomocysteinemia （HHCY） has been recognized as one of causal factors for an independent factor for the atherothromobosis and endovascular injury,it has become an element of great interest of research.HCY has close association （between HCY and different diseases） particularly in rheumatoid arthritis （RA） and in cardio and cerebro-vascular diseases.The capability of HCY to the vascular damage and structurally modifying specific proteins,resulting in formation of neo-antigens may also be a triggering factor of autoimmune reactions and thus HCY has probability to present itself as an initiating factor in autoimmune disease like RA.These all circumstances point towards potentially relevant role of HCY in the onset of specific autoimmune disease.HCY causes or plays a role in the progression of the associated cardiovascular and cerebrovascular damage through its inflammatory property.Immuno-inflammatory activation may contribute to the increase in HCY level which in turn may add up to the injury of the specific organ in specific diseases （like vessel injury in cardio and cerebrovascular disease,synovial tissue in RA）.This bi-directional link appears to connect HCY and the auto-immune disease （immuno-inflammatory activation）.In this review authors have tried to present the potential relation of HCY as a common linking factor between stroke and RA,through its bi-directional property.Through this current opinion authors have tried to put forth opinion that HCY is one of the common causal factors in strokeas as well as in RA.This carries an interesting clinical importance in control and prevention of these two diseases of different entity at a common point.