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Folic and folinic acid load tests for dynamic assessments of compliance and metabolism in folate deficiency and hyperhomocysteinaemia patients unresponsive to high-dose folate replacement.
Ann Clin Biochem
January 2025
Clinical Haematology, New Cross Hospital, Black Country Pathology Services, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
We describe the utility of 'folic and folinic acid load tests' in the investigation of a 26-year-old woman with persistently low serum folate and moderate hyperhomocysteinaemia unresponsive to folic acid supplements. Serum folate, plasma 5-methyltetrahydrofolate (5-MTHF), red cell 5-MTHF and plasma total homocysteine at baseline, 2-h, 4-h and 2- or 4-days (if applicable) post administration of a large dose of oral folic acid, or oral or parenteral folinic acid were measured. The tests confirmed non-compliance but also suggested an unsuspected possible defect in the folate pathway based on differential response to folic versus folinic acid supplements.
View Article and Find Full Text PDFIntegration of genomics, clinical characteristics and baseline biological profiles to predict the risk of liver injury induced by high-dose methotrexate.
Front Pharmacol
November 2024
Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China.
Background: High-dose methotrexate (HD-MTX) is commonly employed in the treatment of malignant tumors in children and young adults due to its distinctive therapeutic efficacy. Nonetheless, the systemic exposure to MTX often results in liver injury (drug induced liver injury, DILI), thereby imposing limitations on the sustained administration of HD-MTX. Additionally, individual variations including genetic underpinnings attributable to disparities in therapeutic effects and clinical toxicity remain to be elucidated.
View Article and Find Full Text PDFAntenatal Care Strategies to Improve Perinatal and Newborn Outcomes.
Neonatology
November 2024
Institute for Global Health and Development, The Aga Khan University, Karachi, Pakistan.
Background: Antenatal care strategies (ANC) play a pivotal role in ensuring a healthy gestational period for expectant mothers and promote optimal outcomes for their babies. Implementing these interventions can contribute to a supportive environment for pregnant women, resulting in positive perinatal and neonatal outcomes.
Summary: We summarize evidence for a total of twenty-seven interventions pertaining to ANC from Every Newborn Series published in The Lancet 2014 by identifying the most recent systematic reviews, extracting data from each review, and conducting a subgroup analysis for low-income and lower-middle-income countries (LMICs) for outcomes relevant to maternal and neonatal health.
High-dose folic acid use and cancer risk in women who have given birth: A register-based cohort study.
Epilepsia
November 2024
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Article Synopsis
- The study aimed to investigate if high-dose folic acid (>1 mg daily) use in women who have given birth and those with epilepsy is linked to a higher risk of cancer, especially in children born to mothers with epilepsy.
- Researchers analyzed data from medical birth registers in Denmark, Norway, and Sweden, tracking cancer diagnoses among women over time while taking into account other factors like antiseizure medication use.
- Results showed that women exposed to high-dose folic acid had a 20% increased overall risk of cancer, which slightly decreased when considering a 6-month delay, with a notable increase in non-Hodgkin lymphoma cases among those exposed.
Excess Folic Acid Exposure Increases Uracil Misincorporation into DNA in a Tissue-Specific Manner in a Mouse Model of Reduced Methionine Synthase Expression.
J Nutr
November 2024
Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States. Electronic address:
Article Synopsis
- Folate and vitamin B12 are key players in a metabolic process that helps produce important molecules for DNA synthesis, and deficiencies can lead to problems like uracil misincorporation into DNA.
- The study examined how reduced levels of a B12-related enzyme interact with high folic acid diets in mice, focusing on folate distribution and genome stability markers.
- Results showed that high dietary folic acid increased folate levels in some tissues and uracil in DNA, but not significantly in the liver, indicating that high folic acid intake has complex effects on folate metabolism and DNA stability.
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