Fig. 1From: Therapeutic potential of folic acid supplementation for cardiovascular disease prevention through homocysteine lowering and blockade in rheumatoid arthritis patientsHomocysteine metabolism and major factors associated with hyperhomocysteinemia in rheumatoid arthritis patients. MTHFR methylene tetrahydrofolate; CBS cystathione β synthase; BHMT betaine homocysteine methyltransferase; MS methionine synthase; Vit vitamin; DMARDs disease-modifying antirheumatic drugs. Vit B9 depletion owing to immuno-inflammatory activation, DMARDs, and gastrointestinal disturbance impairs the MTHFR vit B9-dependent remethylation pathway together with the MTHFR C677T mutation; vit B12 depletion owing to both immuno-inflammatory activation and gastrointestinal disturbance impairs the MS vit B12-dependent remethylation pathway; vit B6 depletion owing to immuno-inflammatory activation and gastrointestinal disturbance impairs the CBS vit B6-dependent transsulfuration pathwayBack to article page