A humble opinion about study on methotrexate toxicity related gene polymorphism

Abstract

Methotrexate (MTX) has been used clinically for nearly 70 years. It has been proved in practice that MTX is effective in some hematologic neoplasms and autoimmune diseases, but it has strong toxic side effects and needs individualized medication. Polymorphisms of some genes affecting MTX metabolism, transport and target of action, such as methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C, gamma-glutamyl hydrolase (GGH) C401T and C16T, solute carrier family 19-A1 (SLC19A1) G80A, are closely related not only to efficacy, but also to toxic side effects of MTX therapy. However, the results of different studies are quite different. At present, it is not possible to use these genetic polymorphisms to guide clinical individualized treatment accurately. Blood concentration monitoring is still the main method of MTX monitoring. \n \n \nKey words: \nMethotrexate;\xa0Drug monitoring;\xa0Polymorphism, genetic;\xa0Drug toxicity