Abstract: Embodiments of the instant disclosure relate to novel compositions and methods for treating a subject having genetic homocystinuria (HCU or other form of genetic homocystinuria). In some embodiments, compositions and methods disclosed herein concern improving efficacy of standard treatments (e.g. trimethylglycine) to reduce dietary compliance requirements and improve outcomes. In accordance with these embodiments, a subject having or suspected of developing classical cystathionine beta-synthase deficient homocystinuria (HCU) or other genetic form of homocystinuria can be treated with a polyamine or diamine or a precursor thereof or a combination thereof for example, in combination with trimethylglycine (e.g. betaine) or other genetic homocystinuria treatment.

Abstract: Embodiments of the instant disclosure relate to novel compositions and methods for treating a subject having homocystinuria. In some embodiments, compositions and methods disclosed herein concern improving efficacy of betaine to reduce dietary compliance requirements and improve outcomes. In accordance with these embodiments, a subject having or suspected of developing homocystinuria can be treated with formate, a salt thereof, a formate derivative or formate precursor or prodrug agent alone or in combination with trimethylglycine or other HCU treatments. In other embodiments, a subject having or suspected of developing homocystinuria can be treated with zinc and/or trimethylglycine and/or formate derivative to treat homocystinuria in the subject. In other embodiments, a subject having or suspected of developing Nonketotic hyperglycinemia (NKH) can be treated with formate, a salt thereof, a formate derivative, or formate precursor or prodrug agent to treat NKH in the subject.