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Pharmacogenetics of thiopurines for inflammatory bowel disease in East Asia: prospects for clinical application of NUDT15 genotyping

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Pharmacogenetics of thiopurines for inflammatory bowel disease in East Asia: prospects for clinical application of NUDT15 genotyping

Journal of Gastroenterology

First published: 30 November 2017

DOI: https://doi.org/10.1007/s00535-017-1416-0 

Yoichi Kakuta, Yoshitaka Kinouchi, Tooru Shimosegawa

Objective: Inflammatory bowel diseases (IBDs), represented by ulcerative colitis and Crohn’s disease, are chronic inflammatory intestinal conditions of unknown etiology. 

Methods: The thiopurine drugs 6-mercaptopurine (6-MP) and azathiopurine (AZA) are widely used to treat inflammatory bowel disease. However, the incidence of adverse reactions is high, particularly in Asia, and the mechanisms of toxicity in Asian populations remain unclear. Thiopurine S-methyltransferase (TPMT) is a well-known enzyme that inactivates AZA or 6-MP through methylation and is one of the few pharmacogenetic predictors used in clinical settings in Western countries. 
  

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