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By contrast, in the GSH-C4-first sequence (Figure 3B), HA + GSH-C4 elicited a reproducible cytokine activation profile: at V3, levels of IFN-2 (p = 0.044), IFN- (p = 0.023), TNF- (p = 0.039), IL-6 (p = 0.044), IL-12p70 (p = 0.015), IL-23 (p = 0.034), and the epithelial alarmin IL-33 (p = 0.023) were significantly elevated versus baseline, whereas IL-1, MCP-1, IL-8, IL-10, and IL-18 remained unchanged

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Because vitamin (especially folate) supplementation can efficiently reduce plasma homocysteine levels, further prospective cohort studies and ongoing, randomized, placebo-controlled trials will determine the efficiency of folate supplementation, possibly in combination with vitamins B 12 and B 6 , in the prevention and correction of vascular disorders related to moderate hyperhomocysteinemia