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BRS2-2-5 - Transsulfuration Pathway
(Converting Homocysteine and Serine into Cysteine)
1. Mission & Overview
Mission
Divert homocysteine toward cysteine so methylation demand is balanced against sulfur amino-acid and redox needs.
Intervention Dominance: Diet-Dominant
Vitamin B6 supplies an essential enzyme cofactor. Comparative intervention dominance and benefit from additional intake are not established; moderate restriction altered cystathionine handling without lowering total pathway flux. [7]
- Pyridoxal 5′-phosphate (PLP; active vitamin B6 cofactor)
- Vitamin B6
- Homocysteine
- Serine
- Cystathionine
-
Combined folate/choline donor availability
-
Methionine-cycle sulfur supply
Individual KC inputs
- Methionine
Overview
Cystathionine beta-synthase joins homocysteine and serine to form cystathionine. [1] [2] Cystathionine gamma-lyase then cleaves cystathionine and releases cysteine. [3] [4] Both enzymes require pyridoxal 5′-phosphate, the active cofactor made from vitamin B6. [1] [5] This irreversible branch disposes of homocysteine and produces cysteine. [3] Studies of the purified enzymes establish these reactions and the cofactor requirement. [1] [2]
- Benefits: Transsulfuration directs sulfur from homocysteine toward cysteine. [3] Cells can later use that cysteine to make glutathione, which links this branch to antioxidant defence.
- Implementation Notes: Vitamin B6 is the dietary source of pyridoxal 5′-phosphate. [1] [5] Homocysteine, serine, and cystathionine are substrates already in the pathway, not dietary targets. These enzyme studies do not show that eating more vitamin B6 speeds this conversion in people. [5]
- Biological Relevance: Glutathione synthesis is a later, separate use of the cysteine made here. [3]
2. Primary Biological Effects
↑ cystathionine formation from homocysteine and serine
↑ cysteine release from cystathionine
↑ irreversible disposal of homocysteine through this branch
3. Intervention Levers
No preparation, supplement, fasting, or circadian practice assessed here has been shown to change this homocysteine-to-cysteine conversion.
No sleep, activity, or stress-recovery practice assessed here has been shown to change this homocysteine-to-cysteine conversion.
4. Mechanistic Basis
Summary
Homocysteine can leave the methyl cycle when it is joined to serine and the product is cleaved to cysteine. Those two enzyme steps set the chemistry of this conversion. They do not, by themselves, show how a change in vitamin B6 intake changes the rate in people.
(Homocysteine and serine become cystathionine)
Cystathionine beta-synthase condenses L-homocysteine and L-serine to L-cystathionine. The reaction requires pyridoxal 5'-phosphate (PLP), the active cofactor form of vitamin B6 [Belew et al. (2009) [1]; Meier et al. (2001) [2]]. Both amino acids are substrates. Homocysteine is the sulfur amino acid coming from the methionine cycle. Serine is the cosubstrate that CBS condenses with it.
(Cystathionine cleavage releases cysteine)
Cystathionine gamma-lyase (CGL; also called CSE) is PLP-dependent and cleaves L-cystathionine in the step that produces cysteine [Zhu et al. (2008) [3]; Steegborn et al. (1999) [4]]. Recombinant enzyme work shows strong gamma-lyase activity toward L-cystathionine and only marginal activity toward L-cysteine [4]. Cysteine is the product. It is not a substrate of this conversion.
(Vitamin B6 supplies the cofactor)
Food vitamin B6 is recycled to PLP by pyridoxal kinase, pyridoxine 5'-phosphate oxidase, and phosphatases [di Salvo et al. (2012) [5]]. That salvage route explains why vitamin B6 matters to both enzymes. It does not measure how fast CBS or cystathionine gamma-lyase runs, and it does not show that a larger vitamin B6 intake increases cysteine formation.
(Boundaries of the mechanism)
This conversion is the irreversible route from homocysteine and serine, through cystathionine, to cysteine.
Remethylation of homocysteine belongs to BRS2-FM1-PM1 — Folate/B12-Dependent Homocysteine Remethylation and BRS2-FM1-PM2 — Betaine/BHMT Remethylation. SAMe formation and whole-cycle throughput belong to BRS2-FM1-PM3 — SAMe Synthesis and BRS2-FM1-PM4 — Methionine Cycle Flux.
Glutathione synthesis from cysteine belongs to BRS2-FM2-PM6 — Glutathione Synthesis. Later antioxidant use of glutathione belongs with BRS3 — Inflammation & Oxidative Stress.
(Integration within BRS2)
Within BRS2(FM2) — Transsulfuration & Redox Coupling, this conversion releases the cysteine that glutathione synthesis can use. Homocysteine that is not remethylated is the sulfur substrate of the first step. The split between remethylation and this branch is not measured on this page.
4.1 Scientific Findings (6)
Summary
Purified and recombinant human enzyme studies establish the two transsulfuration reaction boundaries and their PLP dependence: CBS forms cystathionine, and CGL uses it to release cysteine. [1] [2] [4] [3] The findings converge on biochemical pathway identity, including cysteine’s position as a product of the second step. They do not measure whole-body dietary responsiveness or glutathione synthesis, so neither increased flux from extra vitamin B6 nor downstream benefit is established by these assays. Human tracer evidence adds a physiological boundary: moderate vitamin B6 restriction changed cystathionine handling without significantly changing total transsulfuration. [7]
Human cystathionine beta-synthase uses pyridoxal 5'-phosphate to join L-homocysteine and L-serine, forming L-cystathionine. Pyridoxal 5'-phosphate is the active form of vitamin B6 recycled from food.
What this means
Homocysteine and serine are both substrates. The cofactor requirement does not show that eating more vitamin B6 increases cystathionine formation in people.
Evidence confidence: Not yet scored
Finding ID: PM5-F1
Finding Statement: Human cystathionine beta-synthase catalyses a pyridoxal 5'-phosphate-dependent condensation of L-serine and L-homocysteine to L-cystathionine, and pyridoxal 5'-phosphate is the active vitamin B6 cofactor recycled from food.
Synthesised Evidence Confidence: Not yet scored
Synthesis: Purified human enzyme kinetics and a crystal structure agree that cystathionine beta-synthase condenses L-serine and L-homocysteine to L-cystathionine and that the reaction depends on pyridoxal 5'-phosphate. A cofactor review identifies that same molecule as the active form of vitamin B6, recycled from food by the salvage pathway. Together these sources define the first reaction and its cofactor. They do not measure whole-body transsulfuration flux or an intake response.
Synthesis Limitations: The kinetic and structural evidence uses recombinant or crystallised human enzyme, not intact human physiology. The salvage review does not assay cystathionine beta-synthase. Substrate inhibition constants and cofactor identity do not show that ordinary vitamin B6 intake sets the reaction rate.
Evidence Considered:
- Study
- Steady-state kinetics of recombinant human cystathionine beta-synthase purified from E. coli, using a continuous coupled assay for cystathionine formation.
- Population
- Purified recombinant human enzyme; no cells, animals, or human participants.
- Result
- The enzyme condensed L-serine and L-homocysteine to L-cystathionine. L-Homocysteine inhibited the enzyme at higher concentrations. The reverse hydrolysis of cystathionine was slower than the condensation on a specificity basis.
- Effect / Magnitude
- Reported Ki for L-homocysteine was 2.1 ± 0.2 mM. The abstract states that kcat/Km for cystathionine hydrolysis was approximately 2-fold lower than kcat/Km for L-serine in the condensation.
- Evidence Summary
- Direct human-enzyme evidence that both serine and homocysteine are substrates and that pyridoxal 5'-phosphate is required.
- Limitations
- In-vitro kinetics do not establish in-vivo flux, dietary responsiveness, or a phenome outcome.
- Evidence Source
- Bounded external search
- Reference
- [1]
- Study
- X-ray crystal structure of a truncated form of human cystathionine beta-synthase.
- Population
- Crystallised human enzyme; no cells, animals, or human participants.
- Result
- The structure shows a pyridoxal 5'-phosphate-dependent heme protein that catalyses condensation of serine and homocysteine to cystathionine.
- Effect / Magnitude
- No physiological effect size applies to this structure.
- Evidence Summary
- Independent structural support for the same reaction and for pyridoxal 5'-phosphate dependence.
- Limitations
- A static structure of a truncated enzyme does not measure flux, nutrient limitation, or dietary dose response.
- Evidence Source
- Bounded external search
- Reference
- [2]
- Study
- Narrative review of pyridoxal 5'-phosphate availability, salvage enzymes, and consequences of inadequate intracellular cofactor.
- Population
- No new human cohort; review of human biochemistry and clinical cofactor disorders.
- Result
- In humans, pyridoxal 5'-phosphate is recycled from food and from degraded enzymes by pyridoxal kinase, pyridoxine 5'-phosphate oxidase, and phosphatases.
- Effect / Magnitude
- No transsulfuration rate or vitamin B6 intake-response figure is reported.
- Evidence Summary
- Supports the identity of pyridoxal 5'-phosphate as the vitamin B6 cofactor supplied from food. It does not assay this pathway.
- Limitations
- A salvage review cannot show that vitamin B6 intake changes cystathionine beta-synthase flux.
- Evidence Source
- Bounded external search
- Reference
- [5]
Evidence Dependency:
- di Salvo et al. (2012) is also used in PM5-IC1 to bound intake claims. It is not a second measurement of the condensation reaction.
Informs: Stress Reactivity
Human cystathionine gamma-lyase is a pyridoxal 5'-phosphate-dependent enzyme that cleaves L-cystathionine in the transsulfuration step that produces cysteine. Cysteine is the product of this step. Glutathione synthesis is a later pathway.
What this means
Cystathionine is the substrate and cysteine is the product. Cysteine is not a substrate of this conversion, and glutathione synthesis is not this reaction.
Evidence confidence: Not yet scored
Finding ID: PM5-F2
Finding Statement: Human cystathionine gamma-lyase requires pyridoxal 5'-phosphate and cleaves L-cystathionine in the transsulfuration step that produces cysteine.
Synthesised Evidence Confidence: Not yet scored
Synthesis: Kinetic work on recombinant human cystathionine gamma-lyase shows gamma-lyase activity toward L-cystathionine and only marginal reactivity toward L-cysteine. A separate human-enzyme study identifies the enzyme as pyridoxal 5'-phosphate-dependent and places it in the transsulfuration route that converts homocysteine to cysteine, with cystathionine as the assayed substrate. Cysteine is therefore the pathway product of this step, not its substrate. Neither study measures glutathione synthesis.
Synthesis Limitations: Both studies use recombinant human enzyme. The 2008 paper's numeric comparisons concern disease-associated mutants and a common polymorphism, not dietary intake. The abstracts establish cystathionine cleavage and the homocysteine-to-cysteine role; they were not used as a product-table for every coproduct. Glutathione synthesis remains outside this finding.
Evidence Considered:
- Study
- Cloning of human cystathionine gamma-lyase from Hep G2 RNA, bacterial expression, and steady-state kinetics with L-cystathionine.
- Population
- Purified recombinant human enzyme; no human participants.
- Result
- The enzyme preferred L-cystathionine as a gamma-lyase substrate. Reactivity toward L-cysteine and L-cystine was marginal, and cystathionine beta-lyase activity was not detected.
- Effect / Magnitude
- Reported Km for L-cystathionine was 0.5 mM and Vmax was 2.5 units/mg, with an optimum pH of 8.2.
- Evidence Summary
- Direct kinetic evidence that L-cystathionine is the substrate and that L-cysteine is a poor substrate of this enzyme.
- Limitations
- In-vitro kinetics do not establish in-vivo flux or a dietary response. The abstract does not tabulate every coproduct.
- Evidence Source
- Bounded external search
- Reference
- [4]
- Study
- Kinetic and spectrophotometric comparison of wild-type human cystathionine gamma-lyase with pathogenic mutants and a common polymorphism.
- Population
- Recombinant human enzyme variants; no human participants in the kinetic assays.
- Result
- The polymorphism did not change cofactor content or the tested steady-state parameters. Pathogenic mutants had lower Vmax, lower pyridoxal 5'-phosphate content, and cystathionine Km values comparable to wild type.
- Effect / Magnitude
- T67I Vmax was about 3.5-fold lower and Q240E Vmax about 70-fold lower than wild type. Mutant pyridoxal 5'-phosphate content was about 4-fold and 80-fold lower. Wild-type Km was not stated in the abstract.
- Evidence Summary
- Confirms pyridoxal 5'-phosphate dependence and cystathionine as the substrate in the homocysteine-to-cysteine pathway.
- Limitations
- Mutant fold-changes describe rare enzyme defects, not ordinary diet. The study does not measure glutathione synthesis or recovery.
- Evidence Source
- Bounded external search
- Reference
- [3]
Evidence Dependency:
- Zhu et al. (2008) and Steegborn et al. (1999) are also cited by PM5-F4. That reuse is the same reaction evidence, not a recovery measurement.
Informs: Recovery Capacity
Human methionine tracers measured the methionine-cycle contribution to transsulfuration; moderate vitamin B6 restriction altered cystathionine handling while total transsulfuration was maintained.
What this means
Nine healthy young adults after 28 days of moderate vitamin B6 restriction; whole-body postprandial tracer kinetics, not tissue-specific flux or clinical outcomes. Total transsulfuration was maintained despite altered cystathionine handling. This does not establish increased flux or benefit from additional intake.
Evidence confidence: Not yet scored
Finding ID: PM5-F5
Finding Statement: Moderate vitamin B6 restriction changed cystathionine kinetics without a significant change in total transsulfuration in this small controlled human study.
Synthesised Evidence Confidence: Not yet scored
Synthesis: Lamers and colleagues used labelled methionine to assess whole-body pathway kinetics before and after controlled vitamin B6 restriction. The study supports methionine-cycle supply into the transsulfuration branch and a context-specific B6 response; it does not establish that moderate deficiency lowers net pathway flux.
Synthesis Limitations: Nine healthy young adults after 28 days of moderate vitamin B6 restriction; whole-body postprandial tracer kinetics, not tissue-specific flux or clinical outcomes. Total transsulfuration was maintained despite altered cystathionine handling. This does not establish increased flux or benefit from additional intake.
Evidence Considered:
- Study
- Within-person controlled vitamin B6 restriction with stable-isotope methionine and leucine infusions.
- Population
- Nine healthy young adults (four men, five women), 20–35 years.
- Result
- After 28 days of restriction, cystathionine handling changed while total postprandial transsulfuration, remethylation and transmethylation were maintained.
- Effect / Magnitude
- No significant group change in total transsulfuration; small study does not establish equivalence.
- Evidence Summary
- Direct human kinetic evidence for a bounded response and for methionine-cycle sulfur supply into transsulfuration.
- Limitations
- Nine healthy young adults after 28 days of moderate vitamin B6 restriction; whole-body postprandial tracer kinetics, not tissue-specific flux or clinical outcomes. Total transsulfuration was maintained despite altered cystathionine handling. This does not establish increased flux or benefit from additional intake.
- Evidence Source
- Bounded external search
- Reference
- [7]
Primary protein experiments establish SAM-responsive CBS activation; nutritional effects on net transsulfuration depend additionally on substrate allocation.
What this means
Molecular activation does not establish donor-driven net in-vivo branch allocation. Evidence access: Full primary Methods/Results.
Evidence confidence: Not yet scored
Finding ID: PM5-F6
Finding Statement: Primary protein experiments establish SAM-responsive CBS activation; nutritional effects on net transsulfuration depend additionally on substrate allocation.
Synthesised Evidence Confidence: Not yet scored
Synthesis: Primary protein experiments establish SAM-responsive CBS activation; nutritional effects on net transsulfuration depend additionally on substrate allocation.
Synthesis Limitations: Molecular activation does not establish donor-driven net in-vivo branch allocation. Evidence access: Full primary Methods/Results.
Evidence Considered:
- Study
- Crystallography, mutagenesis and mass spectrometry of human CBS
- Population
- Human protein experiments
- Result
- SAM binding changes regulatory/catalytic domain arrangement and activates CBS.
- Effect / Magnitude
- No general dietary efficacy or tissue-uniform effect is inferred.
- Evidence Summary
- SAM binding changes regulatory/catalytic domain arrangement and activates CBS.
- Limitations
- Molecular activation does not establish donor-driven net in-vivo branch allocation. Evidence access: Full primary Methods/Results.
- Evidence Source
- Bounded external search
- Reference
- [8]
Combined folate/choline deprivation reduced measured hepatic CBS catalytic activity in rats; donor-resource context can therefore constrain this step under that defined deprivation condition. SAM-responsive CBS regulation is a supported connection, not a measured mediator of the dietary effect.
What this means
Four-week combined folate/choline deprivation in male rats on a 20% casein formula with antibiotic suppression of microbial folate synthesis. Extracted liver CBS activity, not in-vivo flux or brain activity, was measured. Neither constituent alone significantly reduced CBS activity in this experiment. SAM mediation is supported mechanistically but was not isolated causally; liver lipid changes accompanied deprivation. This does not establish extra-intake benefit, betaine deficiency or uniform donor limitation.
Evidence confidence: Not yet scored
Finding ID: PM5-F7
Finding Statement: Combined folate/choline deprivation reduced measured hepatic CBS catalytic activity in rats; donor-resource context can therefore constrain this step under that defined deprivation condition. SAM-responsive CBS regulation is a supported connection, not a measured mediator of the dietary effect.
Synthesised Evidence Confidence: Not yet scored
Synthesis: Combined folate/choline deprivation reduced measured hepatic CBS catalytic activity in rats; donor-resource context can therefore constrain this step under that defined deprivation condition. SAM-responsive CBS regulation is a supported connection, not a measured mediator of the dietary effect.
Synthesis Limitations: Four-week combined folate/choline deprivation in male rats on a 20% casein formula with antibiotic suppression of microbial folate synthesis. Extracted liver CBS activity, not in-vivo flux or brain activity, was measured. Neither constituent alone significantly reduced CBS activity in this experiment. SAM mediation is supported mechanistically but was not isolated causally; liver lipid changes accompanied deprivation. This does not establish extra-intake benefit, betaine deficiency or uniform donor limitation.
Evidence Considered:
- Study
- Experiment 2, four diet groups, hepatic homogenate CBS product assay by HPLC; Methods p71, Results and Table 2 p73–74
- Population
- Male Wistar rats, n=8/group, four weeks, 20% casein
- Result
- CBS activity 6.02 ± 0.24 control versus 3.29 ± 0.13 nmol/(min·mg protein) combined deprivation; individual-deprivation groups shared the control significance letter. Hepatic SAM was also lower.
- Effect / Magnitude
- Approximately 45% lower extracted CBS activity in the combined group.
- Evidence Summary
- Combined folate/choline deprivation reduced measured hepatic CBS catalytic activity in rats; donor-resource context can therefore constrain this step under that defined deprivation condition. SAM-responsive CBS regulation is a supported connection, not a measured mediator of the dietary effect.
- Limitations
- Four-week combined folate/choline deprivation in male rats on a 20% casein formula with antibiotic suppression of microbial folate synthesis. Extracted liver CBS activity, not in-vivo flux or brain activity, was measured. Neither constituent alone significantly reduced CBS activity in this experiment. SAM mediation is supported mechanistically but was not isolated causally; liver lipid changes accompanied deprivation. This does not establish extra-intake benefit, betaine deficiency or uniform donor limitation.
- Evidence Source
- Bounded external search
- Reference
- [9]
Exogenous labelled serine contributed to methionine and cystathionine labelling in a human pilot.
What this means
Intravenous single-person tracer study is not an oral serine intervention or proof of an effective food intake. Compartmental pools and routes are inferred from labelling.
Evidence confidence: Not yet scored
Finding ID: PM5-F8
Finding Statement: Exogenous labelled serine contributed to methionine and cystathionine labelling in a human pilot.
Synthesised Evidence Confidence: Not yet scored
Synthesis: Exogenous labelled serine contributed to methionine and cystathionine labelling in a human pilot.
Synthesis Limitations: Intravenous single-person tracer study is not an oral serine intervention or proof of an effective food intake. Compartmental pools and routes are inferred from labelling.
Evidence Considered:
- Study
- Intravenous deuterated serine and leucine tracers.
- Population
- One healthy man.
- Result
- Exogenous labelled serine contributed to methionine and cystathionine labelling in a human pilot.
- Effect / Magnitude
- Only the specified source-level endpoint is assessed; no pooled effect or food-dose estimate is inferred.
- Evidence Summary
- Isotopic product labelling and compartmental kinetic interpretation.
- Limitations
- Intravenous single-person tracer study is not an oral serine intervention or proof of an effective food intake. Compartmental pools and routes are inferred from labelling.
- Evidence Source
- Bounded external search
- Reference
- [10]
Evidence Dependency:
- The source-specific observations support different links; food composition, biochemical identity, intervention exposure and clinical outcomes are not interchangeable. Reuse across PMs is not independent replication.
5. BRS Pathways and Connections
5.1 BRS Pathways
BRS2-FM2-PM5 — Transsulfuration Pathway ↓ BRS2-FM2-PM6 — Glutathione Synthesis
5.2 Cross-BRS Mechanism Relationships
- None listed
5.3 Local BRS Mechanism Relationships
- BRS2-FM2-PM6 — Glutathione Synthesis — Cysteine released when cystathionine is cleaved is the sulfur amino acid consumed when glutathione is assembled. Assembly of glutathione, and the redox reactions that spend it, sit outside this conversion.
7. Phenome Connections
These mappings are translational relationships, not single-mechanism outcome claims. Phenomes are emergent functional patterns supported by multiple interacting PMs across the BRAIN Framework.
Each Phenome relationship has two independent ratings. They are not combined or averaged.
Biology → Phenome Relationship Strength
How direct and important is this biological mechanism expected to be to the Phenome within the BRAIN model?
Evidence Confidence
How strongly does the adjudicated evidence support this particular biology → Phenome relationship?
- Biology → Phenome Relationship Strength: Low–Medium
- Evidence Confidence: Low–Medium
- Rationale: Homocysteine can be joined to serine and then cleaved to cysteine, but that chemistry is not evidence of a stress-reactivity effect. A study of boys with ADHD found higher serum homocysteine and lower vitamin B12. It did not measure these enzymes, cysteine production, or stress outcomes, and it is not a treatment result Lukovac et al. (2024) [6].
Supporting evidence
A paediatric study found higher serum homocysteine and lower vitamin B12 in boys with ADHD than in controls. It did not measure transsulfuration enzymes, cysteine production, stress reactivity, or a treatment effect.
What this means
Homocysteine concentration in that cohort must not be read as evidence that this conversion modulates stress reactivity or treats ADHD or stress.
Evidence confidence: Not yet scored
Finding ID: PM5-F3
Finding Statement: The assessed paediatric ADHD biomarker study does not show that transsulfuration modulates stress reactivity or that it treats stress or ADHD.
Synthesised Evidence Confidence: Not yet scored
Synthesis: The study compared serum homocysteine, vitamin B12, vitamin D, ferritin, and iron in boys with ADHD and age-matched controls. Homocysteine was higher and vitamin B12 was lower in the ADHD group, and the authors treated homocysteine as a possible prognostic marker. The measurements are circulating biomarkers. They do not include cystathionine beta-synthase, cystathionine gamma-lyase, cystathionine, cysteine, pyridoxal 5'-phosphate, stress-reactivity scores, or an intervention.
Synthesis Limitations: This is a gap for the phenome relationship, not proof that no relationship exists. The cohort is boys only, the design is cross-sectional, and diagnosis-marker associations are not pathway flux.
Evidence Considered:
- Study
- Cross-sectional serum biomarker comparison using spectrophotometry and immunoassays, with behavioural and cognitive assessments.
- Population
- 133 boys aged 6.5–12.5 years; 67 with DSM-V ADHD and 66 age-matched controls.
- Result
- Homocysteine was higher and vitamin B12 was lower in the ADHD group. Logistic regression treated homocysteine as a potential prognostic indicator. Vitamin D, ferritin, and iron were also measured.
- Effect / Magnitude
- The abstract reports significant group differences and does not provide the mean concentrations used here.
- Evidence Summary
- Human observational evidence about serum homocysteine and vitamin B12 in paediatric ADHD, not about this enzyme pathway.
- Limitations
- Boys only; no enzyme activity, flux, cysteine, stress-reactivity, or treatment endpoint.
- Evidence Source
- Inherited repository evidence
- Reference
- [6]
Informs: Stress Reactivity
- Biology → Phenome Relationship Strength: Low
- Evidence Confidence: Low
- Rationale: Cysteine released by cystathionine cleavage can be used later for glutathione synthesis, which is a separate mechanism. The enzyme studies do not measure recovery capacity, and they do not show that changing this conversion treats recovery Zhu et al. (2008) [3]; Steegborn et al. (1999) [4].
Supporting evidence
The pathway releases cysteine. Later glutathione synthesis can use that cysteine, but the assessed enzyme evidence does not measure recovery capacity.
What this means
An indirect biological bridge to recovery is not a recovery outcome and is not a treatment claim.
Evidence confidence: Not yet scored
Finding ID: PM5-F4
Finding Statement: Cysteine produced by cystathionine cleavage can supply later glutathione synthesis, but the assessed evidence does not measure recovery capacity.
Synthesised Evidence Confidence: Not yet scored
Synthesis: Human cystathionine gamma-lyase studies establish cleavage of cystathionine in the step that produces cysteine. Glutathione synthesis is a downstream use of cysteine and is outside this mechanism. Neither enzyme paper measures recovery, stress, or a clinical outcome. The recovery relationship therefore stays an indirect framework bridge.
Synthesis Limitations: The finding bounds the enzyme corpus. It does not review glutathione trials, and those trials would belong to glutathione synthesis rather than to this conversion.
Evidence Considered:
- Zhu et al. (2008) [3] — Cellular / Molecular — Exposure: isolated-substance — Human cystathionine gamma-lyase takes part in homocysteine-to-cysteine conversion and does not measure recovery.
- Steegborn et al. (1999) [4] — Cellular / Molecular — Exposure: isolated-substance — Human cystathionine gamma-lyase cleaves L-cystathionine and shows little activity toward L-cysteine. Recovery was not measured.
Evidence Dependency:
- Zhu et al. (2008) and Steegborn et al. (1999) are the same studies as in PM5-F2. PM5-F4 uses them only to keep the product boundary distinct from recovery.
Informs: Recovery Capacity
Stage 2A/2B dietary-target assessment — 23 October 2026
ENRICHED. CBS/CTH routing from homocysteine through cystathionine to cysteine.
Serine and B6/PLP are already admitted. Add a human serine-tracer Finding and composition-supported provisional serine foods; retain single-person, intravenous and compartment-inference limits. No new substrate admission or extra-serine benefit is claimed.
New implementation: 0 dietary-input admissions (0 completed Unset candidates), 0 practices, 0 biochemical participants, 1 unscored Findings. Existing accepted inputs, source assessments, mission, KCs, Phenome relationships and scores are retained.
Source-to-claim boundary: Assessment source. Stop after adjudicating the stated material candidate and tracing supported delivery. Keep uncertain specificity, formulation, anatomical or measurement links explicit; no negative evidence is inferred from incomplete retrieval.
8. References
- [1] Belew et al. (2009) — Human CBS kinetics with serine and homocysteine
- [2] Meier et al. (2001) — Human CBS structure and PLP dependence
- [3] Zhu et al. (2008) — Human CGL kinetics and PLP cofactor
- [4] Steegborn et al. (1999) — Human CGL cleavage of cystathionine
- [5] di Salvo et al. (2012) — Vitamin B6 salvage to pyridoxal phosphate
- [6] Lukovac et al. (2024) — Homocysteine biomarkers in paediatric ADHD
- [7] Lamers et al. (2011) — Moderate vitamin B6 restriction and transsulfuration kinetics
- [8] McCorvie et al. (2014) — SAM Activation of Human CBS
- [9] Liu et al. (2012) — Combined Donor Deprivation and Hepatic CBS Capacity
- [10] Gregory et al. (2000) — Primed, constant infusion with (2H3)serine allows in vivo kinetic measurement of serine turnover, homocysteine remethylation, and transsulfuration processes in human one-carbon metabolism.
No validated structured conversion route is currently projected for this PM. This does not remove or reclassify its existing dietary inputs.
Mapping state: admitted-food-targets-resolved.