Biomarkers for gastrointestinal adverse events related to thiopurine therapy

Abstract

Thiopurines are immunomodulators used in the treatment of acute lymphoblastic leukemia and inflammatory bowel diseases. Adverse reactions to these agents are one of the main causes of treatment discontinuation or interruption. Myelosuppression is the most frequent adverse effect; however, approximately 5%-20% of patients develop gastrointestinal toxicity. The identification of biomarkers able to prevent and/or monitor these adverse reactions would be useful for clinicians for the proactive management of long-term thiopurine therapy. In this editorial, we discuss evidence supporting the use of PACSIN2 , RAC1 , and ITPA genes, in addition to TPMT and NUDT15, as possible biomarkers for thiopurine-related gastrointestinal toxicity.

Total Glucosides of Paeony Attenuates Ulcerative Colitis via Inhibiting TLR4/NF-<i>κ</i>B Signaling Pathway

“…The main therapeutic drugs for UC are salicylic acids, immunosuppressants and corticosteroids, but their clinical cure rates are usually unsatisfactory, and it is easy to relapse after drug withdrawal. In addition, the adverse reactions caused by these drugs could not be ignored, e.g., leucopenia caused by 5aminosalicylic acid (Qiu et al 2015;Santos et al 2022), myelosuppression caused by immunosuppressant (Zudeh et al 2021;Prabha and Khare, 2022), and osteoporosis caused by corticosteroid (Laurent et al, 2022;Migliorini et al 2022). Some rare and severe adverse reactions have also been reported, e.g., acute pancreatitis caused by 5aminosalicylic acid (Kim et al 2007;Correia et al 2021) and fatal rhinocerebral Bing Ji Qi Yi Bao Ming Ji" is as follows: Paeonia lactiflora 30 g, Angelica sinensis 15 g, Coptis chinensis Franch 15 g, Areca catechu L. 6 g, Aucklandia lappa Decne.…”