medigraphic.com
SPANISH

Gaceta Médica de México

ISSN 0016-3813 (Print)
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2008, Number 5

<< Back Next >>

Gac Med Mex 2008; 144 (5)

Farmacogenómica del metotrexate: estrategia para una terapéutica más individualizada en pacientes con artritis reumatoide

Mena-Ramírez JP, Salazar-Páramo M, Dávalos-Rodríguez IP
Full text How to cite this article

Language: Spanish
References: 11
Page: 449-452
PDF size: 40.29 Kb.


Key words:

MTHFR, methotrexate, rheumatoid arthritis, pharmacogenomics.

ABSTRACT

Rheumatoid arthritis (RA) is a common rheumatic disease in Mexico. Methotrexate (MTX) is a drug frequently used in the treatment of this disease. However, treatment discontinuation due to side effects is also common. Inter-individual differences in effectiveness and occurrence of side effects in RA patients treated with MTX (RA-MTX) have been reported. Several studies analyzed the presence of MTHFR C677T and A1298C polymorphisms in RAMTX patients associated with effectiveness, side effects and toxicity. Given the high frequency of the MTHFR C677T polymorphism in Mexico, it is of utmost interest to determine the allelic and genotypic frequency of these polymorphisms in patients with RA-MTX. The use of molecular techniques, feasible in our country, such as PCR/ RFLP (Polymerase Chain Reaction-Restriction Fragment Length Polymorphism) can allow us to identify these MTHFR genotypes among RA-MTX patients in order to target patients at risk of developing drug toxicity, side effects or better MTX efficacy. The ultimate goal is to develop individualized treatment, as promised by the field of pharmacogenomics.


REFERENCES

  1. Secretaría de Salud, México, enero 03, 2007, Disponible en http:// www.salud.gob.mx/ssa_app/noticias/datos/2007-01-03_2732.html

  2. Weinblatt ME, Maier AL, Fraser PA, Coblyn JS. Longterm prospective study of methotrexate in rheumatoid arthritis: Conclusion after 132 months of therapy. J Rheumatol 1998;25:238-242.

  3. Hughes LB, Beasley TM, Patel H, Tiwari HK, Morgan SL, Baggott JE, et al. Racial/ethnic differences in allele frequencies of single nucleotide polymorphisms in the methylenetetrahydrofolate reductase gene and their influence on response to methotrexate in rheumatoid arthritis. Ann Rheum Dis 2006;65:1213-1218.

  4. Van Ede AE, Laan RF, Blom HJ, Huinzinga CJ, Giesendorf BA, de Boo TM, et al. The C677T mutation in the methylenetetrahydrofolate reductase gene: A genetic risk factos for methotrexate-related elevation of liver enzymes in rheumatoid arthritis patients. Arthritis Rheum 2001;44:2525-2530.

  5. Hider S, Buckley C, Silman AJ, Symmons DP, Bruce IN. Factors influencing response to disease modifying antirheumatic drugs in patients with rheumatoid arthritis. J Rheumatol 2005;32:11-16.

  6. van der Put NM, Gabreels F, Stevens EM, Smeitink JA, Trijbels FJ, Eskes TK, et al. A second common mutation in the methylenetetrahydrofolate reductase gene: An additional risk factor for neural-tube defects? Am J Hum Genet 1998;62:1044-1051.

  7. Frosst P, Blom H, Milos R. Identification of a candidate genetic risk factor for vascular disease: A common mutation in methyllenetetrahydrofolate reductase gene. Nat Genet 1995;10:111-113.

  8. Mutchinick OM, López MA, Luna L, Waxman J, Babinsky VE. High prevalence of the thermolabile methylenetetrahydrofolate reductase variant in Mexico: A country with a very high prevalence of neural tube defects. Mol Genet Metab 1999;68:461-467.

  9. Dávalos IP, Olivares N, Castillo MT, Cantú JM, Ibarra B, Sandoval L, et al. The C677T polymorphism of the methylenetetrahydrofolate reductase gene in Mexican mestizo neural-tube defects parents, control mestizo and native populations. Ann Génetique 2000;43:89-92.

  10. Dávalos IP, Mena JP, Bañuelos-Gallo D, Sánchez-Hernández JD, Sandoval L, González-López L, et al. Variant C677T in the methylenetetrahydrofolate reductase gene in patents with rheumatoid arthritis treated with methotrexate. Implication with an increase in the level transaminases. J Rheumatol 2006;33:418-A51.

  11. Kremer MJ. Methotrexate pharmacogenomics. Ann Rheum Dis 2006;65:1121- 1123.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Gac Med Mex. 2008;144