Hyperhomocysteinemia and Cytokine Profiles in Henoch-Schönlein Purpura: Genetic Associations and Treatment Outcomes-Scilight

Trends in Immunotherapy

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Hyperhomocysteinemia and Cytokine Profiles in Henoch-Schönlein Purpura: Genetic Associations and Treatment Outcomes

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https://doi.org/10.54963/ti.v9i2.1192
Ormonbek Dzhakypbaev, Akmatbek Saparbaev, Rysbek Sadyjev, Asel Kenzheeva, Kunduz Shuku‑ ralieva, Nurzhan Usenova, & Sagynali Mamatov. (2025). Hyperhomocysteinemia and Cytokine Profiles in Henoch-Schönlein Purpura: Genetic Associations and Treatment Outcomes. Trends in Immunotherapy, 9(2), 95–106. https://doi.org/10.54963/ti.v9i2.1192
Volume. 9, Issue. 2 ( 2025)
Copyright (c) 2025 Ormonbek Dzhakypbaev, Akmatbek Saparbaev, Rysbek Sadyjev, Asel Kenzheeva, Kunduz Shuku‑ ralieva, Nurzhan Usenova, Sagynali Mamatov
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Authors

  • Ormonbek Dzhakypbaev

    Department of Hospital Internal Medicine with a Course of Hematology, I. K. Akhunbaev Kyrgyz State Medical Academy, Bishkek 720020, Kyrgyzstan
  • Akmatbek Saparbaev

    Department of Physics, Informatics and Mathematics, I. K. Akhunbaev Kyrgyz State Medical Academy, Bishkek 720020, Kyrgyzstan
  • Rysbek Sadyjev

    Department of Therapeutic Dentistry, I. K. Akhunbaev Kyrgyz State Medical Academy, Bishkek 720020, Kyrgyzstan
  • Asel Kenzheeva

    Department of Therapeutic Dentistry, I. K. Akhunbaev Kyrgyz State Medical Academy, Bishkek 720020, Kyrgyzstan
  • Kunduz Shuku‑ ralieva

    4Department of Therapeutic Dentistry, I. K. Akhunbaev Kyrgyz State Medical Academy, Bishkek 720020, Kyrgyzstan
  • Nurzhan Usenova

    Department of Therapeutic Dentistry, I. K. Akhunbaev Kyrgyz State Medical Academy, Bishkek 720020, Kyrgyzstan
  • Sagynali Mamatov

    Department of Hospital Internal Medicine with a Course of Hematology, I. K. Akhunbaev Kyrgyz State Medical Academy, Bishkek 720020, Kyrgyzstan

Received: 23 April 2025; Revised: 19 May 2025; Accepted: 23 May 2025; Published: 6 June 2025

Henoch-Schönlein purpura (HSP) is a systemic vasculitis characterized by purpura, joint pain, abdominal discomfort, and renal involvement in children. This study aimed to evaluate the homocysteine (Hcy) levels, polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) C677T and methionine synthase (MTR) A2756G genes, and immunological parameters in 183 patients with HSP. Hyperhomocysteinemia (HHcy) was found in 67.5% of patients, with 66.6% and 7.4% of patients with HHcy having MTHFR C677T heterozygosity and homozygosity, respectively. MTR A2756G polymorphisms were present in 44.4% of patients with HHcy. Patients with both HHcy and gene mutations experience more severe symptoms. Flow cytometry revealed reduced CD4 and CD8 antigen expressions in some patients. Serum cytokine analysis showed significantly higher IL-6 and TNF-α levels in patients with generalized HSP than in controls and those with cutaneous-articular HSP. Immunomodulatory treatments, such as cyclosporin A and rituximab, were effective in severe, treatment-resistant cases, reducing symptoms and inflammatory markers in these patients. This study highlights the importance of genetic, metabolic, and immunological assessments in guiding personalized treatment for HSP. Recommendations include measuring Hcy levels, genotyping for MTHFR C677T and MTR A2756G polymorphisms, immunophenotyping, and considering immunomodulatory treatments in cases that are severe.

Keywords:

Henoch‑Schö nlein Purpura; IgA Immune Complexes; Homocysteine; Cytokines; Cyclosporin‑A; Ritux‑ imab

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