Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the 1st hr after feeding folic acid-(3)H ((3)H-PteGlu) to fasting human volunteers, plasma S. faecalis and (3)H activity were elevated to an equivalent degree, whereas after this, the (3)H activity exceeded S. faecalis activity, which suggests gradual conversion of folic acid-(3)H to methyltetrahydrofolate-(3)H (5-CH(3)H(4) PteGlu). The increase of L. casei activity exceeded the increase of S. faecalis and (3)H activity, which is consistent with flushing of endogenous methyltetrahydrofolate from the tissues by the administered folic acid-(3)H. Feeding of 5-formyltetrahydrofolate (+/-5CHOH(4)PteGlu) produced a large increase of plasma L. casei activity and only a slight increase of S. faecalis and P. cerevisiae activity, which is consistent with very rapid conversion of folinic acid to methyltetrahydrofolate. Bile folate concentration determined microbiologically was 2.3-9.8 times plasma folate. 40-80% of the bile folate was S. faecalis-active and 20-35% P. cerevisiae-active. Chromatography of bile folates on TEAE-cellulose showed several folates including four tentatively identified as 10-formyltetrahydrofolate (10-CHO-H(4)PteGlu), 10-formylfolate (10-CHO-PteGlu), and/or 10-formyldihydrofolate (10-CHOH(2)PteGlu), methyltetrahydrofolate, and possibly a triglutamate folate. After folate ingestion bile folate concentration increased rapidly. The distribution of bile folates measured by microbiological assay was similar after either folic or folinic acid feeding. Most of the (3)H label of folic acid-(3)H appeared in the biological folates of bile rather than in the folic acid fraction, which shows that the administered folic acid was rapidly transformed to other folates. Folate polyglutamate deconjugating enzyme activity was found to be much less than in serum. Polyglutamates of the type found in yeast were not found in bile. It is suggested that biliary folate may reflect the hepatic intracellular oligoglutamate folate pool rather than the folate as it appears in the hepatic portal blood.
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PMID:Folates in plasma and bile of man after feeding folic acid--3H and 5-formyltetrahydrofolate (folinic acid). 499 93

Intravenous methotrexate therapy with subsequent calcium folinate rescue is widely used for treatment of various neoplastic diseases, both in adults and in children. The optimization of the methotrexate dose and/or the calcium folinate rescue is based on pharmacokinetic data calculated from plasma concentrations collected after cessation of the methotrexate infusion. The aim of the present study was to evaluate the possibility of substituting capillary blood samples with blood samples drawn from central venous catheters (PORT-A-CATH) for therapeutic drug monitoring of methotrexate on the pediatric oncology ward. Nine cancer patients (4 females and 5 males; median age: 15 years; range: 5-20 years) were included. The quantitative analysis of methotrexate was carried out by fluorescence polarization immunoassay (FPIA). The concentrations of methotrexate in venous and capillary samples were closely correlated (rs = 0.98; P < 0.0001; n = 71). The venous/capillary plasma concentration ratio was 1.00 [median value; interquartile range (IQR): 0.882-1.094]; for 85% of the data points the ratio was 0.8 to 1.2, independent of drug concentration. The observed plasma concentration differences in blood samples drawn from central venous accesses and obtained from capillary blood samples in this study could have altered the calcium folinate rescue at 1 treatment occasion only. Plotting all measured methotrexate concentration time data for the individual patients during the elimination phase, on a chart including a normal elimination curve, is mandatory to enable proper handling of the subsequent rescue after high-dose methotrexate therapy. Blood sampling from the central venous access can be used only under certain circumstances for therapeutic drug monitoring of methotrexate. Carefully evaluated standardized instructions regarding rinsing, flushing, and discarding waste volumes, as well as precautions to minimize the required blood volume, are needed.
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PMID:Therapeutic drug monitoring of methotrexate on the pediatric oncology ward: can blood sampling from central venous accesses substitute for capillary finger punctures? 1766 99