Pathophysiology of homocysteine: insights into ion channel dysfunction

Homocysteine is a non-proteinogenic amino acid formed during the metabolism of methionine to cysteine and plays a critical role in maintaining cellular homeostasis. Although multiple enzymatic pathways tightly regulate homocysteine levels, their dysfunction can lead to elevated circulating homocysteine, which is recognized as a risk factor for various cardiovascular and neurological disorders. While most evidence linking homocysteine to specific pathologies comes from observational studies, emerging data suggest that dysregulation of ion channels may be an important underlying mechanism. In this review, we summarize the effects of homocysteine on the expression and function of key ion channel families including calcium, sodium, and potassium channels, and discuss their potential pathophysiological implications.