Methotrexate

Methotrexate has a range of different effects and possible applications. It is used in low doses to treat inflammatory diseases, such as rheumatoid arthritis, psoriasis and Crohn’s disease. In these cases methotrexate suppresses the immune system and reduces the inflammation. Methotrexate is administered in high doses as a cytostatic, due to its cancer-inhibiting effect. It is used to treat conditions including bone cancer, breast cancer, bladder cancer, bowel cancer, lymphoma and leukaemia.

Methotrexate and the benefit of DNA analysis

The efficacy of methotrexate and the risk of side effects vary from one individual to another and can be predicted to some extent on the basis of your genes. DNA analysis can therefore be an important tool in optimising your medication.

Acenocoumarol and the MTHFR enzyme

Methotrexate influences folic acid metabolism. This is because polyglutamated methotrexate (a conversion product) inhibits the activity of two enzymes (dihydrofolate reductase and thymidylate synthase) that play a role in the folic acid cycle.

Besides methotrexate, folic acid metabolism is also influenced by the enzyme MTHFR. As a result, genetic variations that lead to an underactive MTHFR enzyme could influence the efficacy and toxicity of methotrexate. Incidentally, the toxicity of methotrexate can be reduced by administering folinic acid and this is a standard procedure in ordinary, everyday practice.

The activity of the enzyme MTHFR can vary considerably depending on your genetic predisposition, which means the efficacy of methotrexate can also differ from person to person, as can the risk of side effects. Information about your genetic predisposition may therefore provide grounds for extra vigilance during a treatment with methotrexate.

Read more about The enzyme MTHFR »
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