The enzyme inosine-5'-monophosphate dehydrogenase (IMPDH) catalyzes the conversion of inosine-5'-monophosphate to xanthosine-5'-monophosphate and is a rate-limiting factor in the de novo synthesis of guanine nucleotides, which are necessary for unimpeded cell growth and proliferation. Genetic polymorphisms in IMPDH1 and IMPDH2 may affect IMPDH activity and, consequently, the pharmacological effects of drugs that act on or are metabolized by IMPDH, including mycophenolic acid and thiopurines. These are immunosuppressive drugs that can cause serious adverse effects, which implies that the correct dosing is very important. By adjusting therapy to genetic factors, we could achieve greater treatment safety, fewer adverse effects, and lower treatment costs. The aim of this study was to investigate the correlation between genetic polymorphisms and IMPDH activity. We conducted a study on a sample of 154 healthy Slovenian volunteers. Individuals were genotyped for the rs2278293, rs2288550, rs558132944, rs121912550, and rs11706052 polymorphisms in IMPDH1 and IMPDH2 using the high resolution melting analysis. IMPDH activity was determined in hemolysates from the same individuals using the HPLC method. First, we determined the allele frequencies of the selected polymorphisms and compared them with the allele frequencies of other populations. The frequency of the rs2278293 polymorphism in the Slovenian population is comparable to the frequencies in the global, European, American and African populations. The frequency of the rs2288550 polymorphism in the Slovenian population is above the global, East Asian, American and African averages and below the European average. The frequency of the rs11706052 polymorphism is comparable among all populations, with the exception of African and East Asian populations. We did not identify the rs558132944 and rs121912550 polymorphisms in the Slovenian population. Furthermore, we found that IMPDH activity in the Slovenian population is normally distributed. Values ranged from 1129 to 4017 nmol XMP/(g Hb*h), with a mean value of 2322 ± 578,4 nmol XMP/(g Hb*h). We found a statistically significant association between IMPDH activity and the rs2288550 polymorphism. Non-variant homozygotes (CC) and heterozygotes (CG) had higher IMPDH activity compared to variant homozygotes (GG). We did not find statistically significant associations between the other investigated polymorphisms and IMPDH activity in the Slovenian population. The association between IMPDH activity and the rs2288550 polymorphism could contribute to a more precise dosing of mycophenolate mofetil and thiopurines.
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