Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0022104 (irritable bowel syndrome)
 8,033 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Azathioprine is an immunosuppressive drug used in the treatment of inflammatory bowel disease. It is a prodrug that is hydrolysed to 6-mercaptopurine, which represents the active form. Azathioprine is also used in the treatment of leukaemia in children and in organ transplantation. Azathioprine treatment is associated with adverse effects such as leukopenia and aplasia. These adverse effects are related to a single nucleotide polymorphism, including the inability of cells to synthesize thiopurine methyltransferase (TPMT). TPMT is a detoxification enzyme that limits 6-thioguanine nucleotide production and thereby interferes with normal DNA and RNA synthesis. This review presents the different approaches used for azathioprine therapeutic monitoring in IBD treatment and discusses the discrepancies in recent clinical trials.
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PMID:[Genetic polymorphism and treatment of chronic bowel inflammatory diseases: the example of azathioprine]. 1519 72

Immunomodulator (thiopurines) and calcineurin inhibitors (cyclosporine, tacrolimus) have been used in IBD treatment. Thiopurines such as azathioprine and 6-mercaptopur- ine are used in steroid refractory and steroid dependent UC patients. They are also concomitant used both in CD and UC with other drugs including anti-TNFa monoclonal Ab mainly as maintenance therapy. Calcineurin inhibitors, cyclosporine and tacrolimus, are used in moderate to severe refractory UC patients. Adverse effects of thiopruine include bone marrow suppression, liver dysfunction, hair loss, and infectious disease. Recently, it was reported that the risk of acute onset leukopenia in thioprine use is associated with NUDT 15 gene variant, especially in Asian population. Renal dysfunction and infectious disease (e. g. pneumocystis) should be concerned in the patientg treated with calcineurin inhibitors.
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PMID:Immunomodulator and calcineurin inhibitors on inflammatory bowel disease. 3056 83