Association of MTHFR and RFC1 gene polymorphisms with methotrexate efficacy and toxicity in Chinese Han patients with rheumatoid arthritis

J Int Med Res. 2020 Feb;48(2):300060519879588. doi: 10.1177/0300060519879588. Epub 2019 Oct 16.

Abstract

Objective: The objective was to explore the association of methylene tetrahydrofolate reductase (MTHFR) C667T and A1298C and reduced folate carrier 1 (RFC-1) A80G single nucleotide polymorphisms (SNP) with rheumatoid arthritis (RA) and efficacy and toxicity of methotrexate (MTX) treatment in Chinese Han patients in Henan, China.

Methods: Two hundred ninety-six patients with RA were enrolled (cases) and 120 healthy individuals served as controls. The genotypes of MTHFR C667T and A1298C SNP and RFC-1 A80G SNP were detected by restriction fragment length polymorphism-PCR and compared between cases and controls. We analyzed correlations of clinical effect, toxicity, and SNPs after 6 months of MTX treatment.

Results: We detected no significant differences in MTHFR C677T and A1298C and RFC-1 A80G SNPs between cases and controls. The RFC-1 A80G SNP differed between RA patients with good and poor efficacy after 6 months of MTX, and was an independent factor of MTX efficacy. The MTHFR C677T SNP was differently distributed in the adverse drug reaction (ADR) and non-ADR groups and was an independent factor of MTX toxicity.

Conclusions: In Chinese Han patients with RA, the MTHFR C667T SNP may correlate with MTX toxicity, whereas the RFC-1 A80G SNP may correlate with MTX efficacy rather than toxicity.

Keywords: MTHFR; RFC-1; Rheumatoid arthritis; efficacy; methotrexate; polymorphism; toxicity.

MeSH terms

  • Antirheumatic Agents* / adverse effects
  • Arthritis, Rheumatoid* / drug therapy
  • Arthritis, Rheumatoid* / genetics
  • China
  • Genotype
  • Humans
  • Methotrexate / adverse effects
  • Methylenetetrahydrofolate Reductase (NADPH2) / genetics
  • Polymorphism, Single Nucleotide / genetics

Substances

  • Antirheumatic Agents
  • MTHFR protein, human
  • Methylenetetrahydrofolate Reductase (NADPH2)
  • Methotrexate