Zudeh G, Franca R, Stocco G, Decorti G. Biomarkers for gastrointestinal adverse events related to thiopurine therapy. World J Gastroenterol 2021; 27(38): 6348-6356 [PMID: 34720526 DOI: 10.3748/wjg.v27.i38.6348]
Corresponding Author of This Article
Gabriele Stocco, PhD, Associate Professor, Department of Life Sciences, University of Trieste, Via Fleming 22, Trieste 34127, Italy. stoccog@units.it
Research Domain of This Article
Pharmacology & Pharmacy
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Giulia Zudeh, Gabriele Stocco, Department of Life Sciences, University of Trieste, Trieste 34127, Italy
Raffaella Franca, Giuliana Decorti, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste 34149, Italy
Giuliana Decorti, Institute for Maternal and Child Health I.R.C.C.S Burlo Garofolo, Trieste 34137, Italy
Author contributions: Zudeh G and Franca R wrote, revised, and edited the manuscript; Stocco G conceptualized, edited, and revised the manuscript; Decorti G conceptualized, wrote, revised, edited, and supervised the manuscript; all authors read and approved the final manuscript.
Conflict-of-interest statement: All authors declare no conflicts of interest for this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gabriele Stocco, PhD, Associate Professor, Department of Life Sciences, University of Trieste, Via Fleming 22, Trieste 34127, Italy. stoccog@units.it
Received: March 12, 2021 Peer-review started: March 12, 2021 First decision: April 17, 2021 Revised: April 29, 2021 Accepted: September 3, 2021 Article in press: September 3, 2021 Published online: October 14, 2021
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.
Core Tip: Adverse reactions to thiopurines are one of the main causes of treatment discontinuation or interruption. In addition to myelosuppression, approximately 5–20% of patients develop gastrointestinal toxicity; the identification of biomarkers to prevent and/or monitor these adverse reactions is important 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.
