Folate (B9) Pathway - CRASH! Medical Review Series

(Disclaimer: The medical information contained herein is intended for physician medical licensing exam review purposes only, and are not intended for diagnosis of any illness. If you think you may be suffering from any medical condition, you should consult your physician or seek immediate medical attention.)

[woloabel]

Folate Cycle, Pathology thereof is herein narrated, including Pharmacology of Folate Antagonistic Agents. Folate absorption occurs within the Duodenum and Jejunum parts of the Small Intestine, whereas Cobalamin is distal of this region (Distal Ileum). Dihydrofolate (DHF) becomes Tetrahydrofolate (THF) via Dihydrofolate Reductase (DHFR) Before Methylation occurs via Methyl Tetrahydrofoate Reducase Enzyme (MTHFR) of 5, 10 Methylenetetrahydrofolate to form 5 Methyltetrahydrofolate (5-MTHF), whereby this Enzyme can become useful in Hemopoiesis and Homocysteine Transamination (Methionine Synthesis). For Thymidylate Synthase and Cobalamin Cofactor (Vitamin B12 Deficiency), it is the Catalysis of Deoxyuridine Monophosphate (dUMP) to Deoxythymidine Monophosphate, where Thymidine thereafter can become a Nucleotide of Deoxyribonucleic Acid (DNA) or RNA Synthesis. Megaloblastic Anemia can be a manifestation of Vitamin B12 Deficiency upon the exclusion of other possible Aetiology (Malabsorption, Intrinsic Factor Deficiency etc). Folate Deficiency is also an Aetiology for Megaloblastic Anemia (CBC and PBS for Diagnosis). Homocystinuria can arise under two possible Pathways: 1) Methionine Synthase Deficiency or 2) Methytetrahydrofolate Reductase Deficiency ( also CBS Deficiency). The Metabolic Inhibitors Agent Fluorouracil (5-FU) antagonizes Thymidylate Synthase along with Capecitabine, Methotrexate (MTX) is a Folic Acid Analog Class of Drug inhibiting Dihydrofolate Reductase or not allowing the activation of Folic Acid (Folate). Trimethoprime (TMP) is an Metabolic Pathway Inhibitor Antibiotic/Antimicrobial and is used along with Sulfamethoxazole (SMX) for E. Coli Urinary Tract Infections also inhibts DHFR Enzyme. Pyrimethamine, Antimalarials Drug Class also inhibits DHFR Activity thereby treating Toxoplasmosis of HIVAIDS Encephalitis. Phenytoin, an Antiepileptic Agent of Anticonvulsants/Hydantoins Drug Class, inhibits epithelial Cells in the Small Intestine from absorbing dietary Folate. This Medication is to be taken in conjunction with aggressive, High Dose Folate Supplementation in Pregnancy (Folate is essential in Embryo Development) or best avoided at once. Goodness, I have just treated a healthy bouncing neonate on a mother who is folate Deficient. The idea is to always avoid Spontaneous Abortions or Teratogenicity by at a minimun giving the Fetus the correct nutrients exposure. MD. Paul Bolin, es immer sehr gut zu Gesundheit bin dass auch. Prost!

[Katie-vyrd]

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