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The un-methylated form, folic acid (vitamin B 9), is a synthetic form of folate, and must undergo enzymatic reduction by dihydrofolate reductase to become biologically active. [1] It is synthesized in the absorptive cells of the small intestine from polyglutamylated dietary folate. It is a methylated derivative of tetrahydrofolate.
Methyl-B 12 converts homocysteine, in a reaction catalyzed by homocysteine methyltransferase, to methionine. A defect in homocysteine methyltransferase or a deficiency of B 12 may lead to a so-called "methyl-trap" of THF, in which THF converts to methyl-THF, causing a deficiency in folate. [ 97 ]
Folinic acid, also known as leucovorin, is a medication used to decrease the toxic effects of methotrexate and pyrimethamine. [2] [3] It is also used in combination with 5-fluorouracil to treat colorectal cancer and pancreatic cancer, may be used to treat folate deficiency that results in anemia, and methanol poisoning.
Tetrahydrofolic acid is a cofactor in many reactions, especially in the synthesis (or anabolism) of amino acids and nucleic acids.In addition, it serves as a carrier molecule for single-carbon moieties, that is, groups containing one carbon atom e.g. methyl, methylene, methenyl, formyl, or formimino.
These 2 chemotherapy protocols are very similar in principle. Both consist of 3 medicinal drugs: a) Leucovorin (= folinic acid = calcium folinate), b) 5-Fluorouracil (= 5-FU), and c) Oxaliplatin. Since these 3 medicinal drugs are "concomitant" to each other, such a constellation is called "concomitant drugs". [1]
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Calcium folinate treatment in cases of blood dyscrasias; Forcing oral fluids; Alkalinisation of the urine may reduce the toxicity of sulfamethoxazole, but it may increase the toxic effects of trimethoprim. [3]
Antifolates are a class of antimetabolite medications that antagonise (that is, block) the actions of folic acid (vitamin B 9). [1] Folic acid's primary function in the body is as a cofactor to various methyltransferases involved in serine, methionine, thymidine and purine biosynthesis.