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Updated: Feb 10, 2026

Measuring RAN Peptide Toxicity in C. elegans
Published on: April 30, 2020
Typing TPMT and ITPase to detect azathioprine toxicity
Monica Arenas1,2,3,4, Anthony Marinaki1,2,3,4, Azhar Ansari1,2,3,4
1Purine Research Laboratory, Guy's Hospital, St Thomas' Street, London SE1 9RT, UK. Monica.arenas_hernandez@kcl.ac.uk.
Abstract:
Genetic variation in thiopurine methyltransferase (TPMT) enzyme activity strongly predicts adverse effects in patients treated with the thiopurine drugs, azathioprine and 6-mercaptopurine, and is one of the classic examples of pharmacogenetics in clinical practice. Recently, polymorphic variation in the gene encoding the enzyme inosine triphosphatase (ITPase) has also been associated with risk of thiopurine-related toxicity. This article reviews the evidence for the role of TPMT and ITPase deficiency as predictors of thiopurine toxicity and makes recommendations for clinical and laboratory practice.
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