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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

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Management of L-Dopa related hyperhomocysteinemia: catechol-O-methyltransferase (COMT) inhibitors or B vitamins? Results from a review

Stefano Zoccolella1 / Giovanni Iliceto2 / Michele deMari3 / Paolo Livrea4 / Paolo Lamberti5

1Department of Neurological Sciences, University of Bari, Bari, Italy

2Department of Neurological Sciences, University of Bari, Bari, Italy

3Department of Neurological Sciences, University of Bari, Bari, Italy

4Department of Neurological Sciences, University of Bari, Bari, Italy

5Department of Neurological Sciences, University of Bari, Bari, Italy

Corresponding author: Prof Paolo Lamberti, Department of Neurological Sciences, University of Bari, Ospedale Policlinico, P.zza G. Cesare 11, 70124 Bari, Italy Phone: +39-080-5592321, Fax: +39-080-5478532,

Citation Information: Clinical Chemical Laboratory Medicine. Volume 45, Issue 12, Pages 1607–1613, ISSN (Online) 14374331, ISSN (Print) 14346621, DOI: 10.1515/CCLM.2007.337, December 2007

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In recent years, L-Dopa treatment has been indicated as an acquired cause of hyperhomocysteinemia (HHcy). The mechanism underlying L-Dopa-related HHcy is the O-methylation of the drug catalyzed by the enzyme catechol-O-methyltransferase (COMT). Folate and cobalamin status also influences the effects of L-Dopa on plasma homocysteine (Hcy) levels. Although clinical correlations of HHcy in Parkinson's disease still remain uncertain, management of elevated plasma Hcy levels has been advocated, due to multiple cytotoxic effects of Hcy on neurons. This review summarizes data available in the literature concerning the two main therapeutic approaches to L-Dopa-related HHcy (use of COMT inhibitors or B vitamins diet supplementation).

Clin Chem Lab Med 2007;45:1607–13.

Keywords: cobalamin; entacapone; folate; homocysteine; L-Dopa; Parkinson's disease; tolcapone

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