Pharmacogenetic approach to preventing folate deficiency: L-5-methyltetrahydrofolate or folic acid?


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Abstract

Objective. To analyze data on the impact of single nucleotide polymorphisms on the metabolic features of different biochemical folate formulations used in clinical practice and to evaluate the efficiency and safety of using folate-containing drugs in the context of pharmacogenetics. Subject and methods. Publications over the past 20 years on the impact of polymorphism in different genes of folate cycle enzymes on the efficiency and safety of using L-methylfolate and folic acid were sought in the NSBI PubMed database. Results. The peculiarities of the use of folate-containing drugs are described and data on the impact of polymorphism in the key genes (MTHFR, MTR, MTRR, SLC19A1, MTHFD1, SHMT1, and DHFR) on the metabolic features of L-methylfolate and folic acid are given. There is strong evidence that multivitamin supplements containing 800 μg of folic acid have a high protective effect in preventing congenital malformations. Conclusion. The use of alternative sources of folates versus traditionally administered folic acid has failed to demonstrate unique advantages, but may be a potentially promising area in a further research search.

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About the authors

A. E Donnikov

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: donnikov@dna-technology.ru
PhD, senior staff scientist of laboratory of molecular genetic methods

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