The role of folates in methanol toxicity

In the monkey and human, methanol toxicity is characterized by a metabolic acidosis and an ocular toxicity which occur coincident with an accumulation of formate in blood. In contrast, methanol insensitive species such as the rat do not accumulate formate after methanol administration. Folate-dependent reactions are involved in the oxidation of formate to CO2 in both the rat and the monkey. Monkey liver contains a significantly lower hepatic folate level than does rat liver and, thus, formate accumulation in the monkey may be related to a functional folate deficiency in this species. Formate metabolism in the monkey can be stimulated with folate administration. After methanol administration, treatment of monkeys with repetitive doses of either 5-formyltetrahydrofolic acid or folic acid results in a marked decrease in blood formate accumulation, an absence of metabolic acidosis and no blood bicarbonate depletion. Also, methanol toxicity, once established in the monkey, can be reversed with 5-formyltetrahydrofolic acid administration. The results indicate that 5-formyltetrahydrofolic acid decreases formate accumulation after methanol by stimulating the rate of formate oxidation or utilization and provide additional evidence for the involvement of folate-dependent reactions in the metabolism and toxicity of methanol in the monkey.