Question

AutoSave OFF A sro - wa Folate metabolism-2 Home Insert Draw Design Layout References Mailings Review View Share Comments A E E AaBbCcDdEe Times New... - 12 A À Aav AO ♡ BI U va x, x? ADA ALT OD | AaBbCcDdEe No Spacing AaBbCcDc AaBb CcDdEt AaBb Heading 1 Heading 2 Title AaBb CcDdE Subtitle AaBbCcDdEe Subtle Emph... Paste 3 Normal Styles Pane Sensitivity 1) Draw a diagram to represent the conversion of folic acid to its metabolically active form, tetrahydrofolate (THF). (2 pt) 2) What is the predominant form of folate found in plasma? (2 pt) 3) Why is folic acid supplementation not effective in patients taking methotrexate? What would be a good alternative to folic acid and why? (2 pt) folate 4) 5-methyltetrahydrofolate reductase (MTHFR) is an important enzyme in metabolism. a. What is the function of MTHFR? (2 pt) b. Which vitamin cofactor is important for MTHFR activity? (2 pt) c. What is the consequence of a mutation in the MTHFR gene leading to a substitution of an alanine for a valine? (2 pt) d. Would folate supplementation be recommended for individuals with polymorphisms in the MTHFR gene? What type of supplement would be ideal? (3 pt) Page 1 of 1 168 words x English (United States) O Focus - 145%

Answer 1

2. 5 methyl tetrahydrofolate is the predominant form of folate in plasma

3. folic acid supplementation is not effective because methotrexate interferes in breakdown of folate and promotes excretion of folate so cause folate deficiency. Folinic acid supplementation should be done instead so as to prevent side effects caused by methotrexate like mouth ulcers, stomach problems etc.

1 A1 HNRL HNRI 1 OH PHHH HI NADPH + HA Le but I .. NADPI Apte tetrahydrefolete folete I diydrofolete cs Scanned with CamScanner

4. a. This enzyme helps in conversion of folate to metabolically active 5 methyl tetrahydrofolate whic is furthur necessary for conversion of homocysteine to methionine.

b. Vit b12 as cofactor

c. There is increased risk for cardiovascular defects and neural tube defects with this mutation.

d. Yes folate supplementation is recommended. Supplements like n acetylcysteine, riboflavin, fish oil , vit c, d, e , methyl b12 should be given in such mutation.