Knowra Methotrexate Methotrexate Methotrexate is an antifolate medication that inhibits dihydrofolate reductase. It is used to treat cancers, autoimmune diseases, and ectopic pregnancy.
Dihydrofolate reductase : An enzyme that regenerates tetrahydrofolate from dihydrofolate, supporting nucleotide synthesis. Methotrexate inhibits this enzyme, restricting folate-dependent DNA synthesis.
Methotrexate chemotherapy : Cancer treatment that uses methotrexate alone or in combination with other anticancer drugs. High doses can exploit impaired nucleotide synthesis to kill susceptible cancer cells.
Low-dose methotrexate : A weekly, generally anti-inflammatory methotrexate regimen used for several autoimmune diseases. Its effects and monitoring differ from the high-dose regimens used in cancer treatment.
Leflunomide : An immunomodulatory drug that inhibits dihydroorotate dehydrogenase and is used to treat rheumatoid arthritis. It is an alternative conventional disease-modifying drug with a different primary molecular target.
Folate : A family of B vitamins needed for one-carbon transfer reactions, including nucleotide synthesis. Methotrexate disrupts the folate pathways cells use to make DNA.
Rheumatoid arthritis : A chronic autoimmune disease in which inflammation damages joints and can affect other organs. Low-dose weekly methotrexate is a standard disease-modifying treatment.
High-dose methotrexate : An intensive cancer-treatment regimen requiring drug-level monitoring and measures to limit toxicity. Kidney clearance, hydration, urine alkalinization, and leucovorin rescue are central to its safe use.
Azathioprine : An immunosuppressive drug that interferes with purine synthesis and is used in autoimmune disease and transplantation. It offers another antimetabolite approach, but acts through purine rather than folate pathways.
Polyglutamation : The addition of glutamate residues to molecules, which can increase their retention within cells. Cells convert methotrexate into polyglutamated forms that persist and inhibit additional folate-dependent enzymes.
Psoriasis : An immune-mediated disease that causes inflamed, scaly patches on the skin. Methotrexate can suppress the immune activity driving extensive or severe disease.
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