THPM1
MCID: THP004
MIFTS: 41

Thiopurines, Poor Metabolism of, 1 (THPM1)

Categories: Blood diseases, Cancer diseases, Genetic diseases, Immune diseases, Metabolic diseases

Aliases & Classifications for Thiopurines, Poor Metabolism of, 1

MalaCards integrated aliases for Thiopurines, Poor Metabolism of, 1:

Name: Thiopurines, Poor Metabolism of, 1 57
Thiopurine S-Methyltransferase Deficiency 57 12 25 37 15 40
Tpmt Deficiency 57 12 25
Thiopurine S-Methyltransferase Deficiency; Tpmtd 57
Thiopurine S Methyltranferase Deficiency 73
Thiopurine Methyltransferase Deficiency 25
Poor Metabolism of Thiopurines-1 12
Poor Metabolism of Thiopurines 25
Thiopurine S-Methyltransferase 13
Poor Thiopurine Metabolism 29
Thpm1 57
Tpmtd 57

Characteristics:

OMIM:

57
Inheritance:
autosomal recessive

Miscellaneous:
increased susceptibility to toxic effects of treatment with 6-mercaptopurine (6mp), 6-thioguanine (6tg), and azathioprine (aza)
heterozygotes may also show increased susceptibility to toxic effects of thiopurine treatment


HPO:

32
thiopurines, poor metabolism of, 1:
Inheritance autosomal recessive inheritance


Classifications:



External Ids:

OMIM 57 610460
Disease Ontology 12 DOID:0080172
MedGen 42 C0342801
KEGG 37 H00964
SNOMED-CT via HPO 69 258211005 191124002 34093004
UMLS 73 C0342801

Summaries for Thiopurines, Poor Metabolism of, 1

OMIM : 57 THPM1 is an autosomal recessive trait associated with severe hematopoietic toxicity when patients are treated with standard doses of the antineoplastic agents 6-mercaptopurine (6MP) or 6-thioguanine (6TG), or the immunosuppressant azathioprine (AZA) (Lennard et al., 1989). The thiopurines are prodrugs that require extensive metabolism in order to exert their cytotoxic action. Azathioprine is nonenzymatically reduced to 6MP. 6MP and 6TG are activated by HPRT (308000) and subsequent steps to form cytotoxic thioguanine nucleotides (TGNs) which are incorporated into DNA and/or RNA, causing DNA-protein cross-links, single-strand breaks, interstrand cross-links, and sister chromatid exchange. TPMT functions mainly to inactivate these drugs; thus, a deficiency of TPMT results in increased conversion to toxic TGNs, which can result in myelosuppression (Coulthard and Hogarth, 2005). However, 6MP is unique in that it can also be converted via TPMT into a methyl-thioinosine 5-prime monophosphate (MeTIMP), a metabolite that inhibits de novo purine synthesis and likely contributes to the cytotoxic effect of 6MP (Vogt et al., 1993; Krynetski et al., 1995; Coulthard and Hogarth, 2005). (610460)

MalaCards based summary : Thiopurines, Poor Metabolism of, 1, also known as thiopurine s-methyltransferase deficiency, is related to thiopurine s methyltranferase deficiency and thiopurines, poor metabolism of, 2. An important gene associated with Thiopurines, Poor Metabolism of, 1 is TPMT (Thiopurine S-Methyltransferase), and among its related pathways/superpathways are Drug metabolism - other enzymes and Metabolism. Affiliated tissues include bone, myeloid and liver, and related phenotypes are abnormality of metabolism/homeostasis and abnormality of blood and blood-forming tissues

Disease Ontology : 12 An inherited metabolic disease that is characterized by significantly reduced activity of an enzyme that helps the body process drugs called thiopurines.

Genetics Home Reference : 25 Thiopurine S-methyltransferase (TPMT) deficiency is a condition characterized by significantly reduced activity of an enzyme that helps the body process drugs called thiopurines. These drugs, which include 6-thioguanine, 6-mercaptopurine, and azathioprine, inhibit (suppress) the body's immune system. Thiopurine drugs are used to treat some autoimmune disorders, including Crohn disease and rheumatoid arthritis, which occur when the immune system malfunctions. These drugs are also used to treat several forms of cancer, particularly cancers of blood-forming tissue (leukemias) and cancers of immune system cells (lymphomas). Additionally, thiopurine drugs are used in organ transplant recipients to help prevent the immune system from attacking the transplanted organ.

Related Diseases for Thiopurines, Poor Metabolism of, 1

Diseases in the Thiopurines, Poor Metabolism of, 1 family:

Thiopurines, Poor Metabolism of, 2

Diseases related to Thiopurines, Poor Metabolism of, 1 via text searches within MalaCards or GeneCards Suite gene sharing:

(show all 41)
# Related Disease Score Top Affiliating Genes
1 thiopurine s methyltranferase deficiency 11.6
2 thiopurines, poor metabolism of, 2 11.1
3 leukemia 10.5
4 systemic lupus erythematosus 10.3
5 lupus erythematosus 10.3
6 crohn's disease 10.3
7 autoimmune hepatitis 10.3
8 hepatitis 10.3
9 autoimmune disease 10.2
10 autoimmune disease 1 10.2
11 alpha/beta t-cell lymphopenia with gamma/delta t-cell expansion, severe cytomegalovirus infection, and autoimmunity 10.2
12 acute leukemia 10.2
13 acute lymphoblastic leukemia, childhood 10.2
14 neuromyelitis optica 10.2
15 neuromyelitis optica spectrum disorder 10.2
16 pancytopenia 10.2
17 leukemia, acute myeloid 10.1
18 leukemia, acute lymphoblastic 10.1
19 ulcerative colitis 10.1
20 inflammatory bowel disease 10.1
21 colitis 10.1
22 lymphocytic leukemia 10.1
23 myeloid leukemia 10.1
24 pulmonary fibrosis, idiopathic 10.1
25 rheumatoid arthritis 10.1
26 aplastic anemia 10.1
27 acute promyelocytic leukemia 10.1
28 pulmonary fibrosis and/or bone marrow failure, telomere-related, 2 10.1
29 arthritis 10.1
30 liver disease 10.1
31 neutropenia 10.1
32 pulmonary fibrosis 10.1
33 uremia 10.1
34 beta-thalassemia 10.0
35 acute lymphocytic leukemia 10.0
36 thalassemia 10.0
37 sclerosing cholangitis 10.0
38 cholangitis 10.0
39 azathioprine or 6-mercatopurine toxicity or dose selection 10.0 NUDT15 TPMT
40 nodular regenerative hyperplasia 9.9 ITPA TPMT
41 adenosine deaminase deficiency 9.8 ITPA PNP

Graphical network of the top 20 diseases related to Thiopurines, Poor Metabolism of, 1:



Diseases related to Thiopurines, Poor Metabolism of, 1

Symptoms & Phenotypes for Thiopurines, Poor Metabolism of, 1

Symptoms via clinical synopsis from OMIM:

57
Hematology:
myelosuppression develops on standard doses of thiopurine drugs
hematopoietic toxicity develops on standard doses of thiopurine drugs

Laboratory Abnormalities:
decreased activity of thiopurine s-methyltransferase
decreased metabolism of thiopurine drugs
increased toxic thioguanine nucleotides (tgns) on standard doses of thiopurine drugs


Clinical features from OMIM:

610460

Human phenotypes related to Thiopurines, Poor Metabolism of, 1:

32
# Description HPO Frequency HPO Source Accession
1 abnormality of metabolism/homeostasis 32 HP:0001939
2 abnormality of blood and blood-forming tissues 32 HP:0001871

Drugs & Therapeutics for Thiopurines, Poor Metabolism of, 1

Search Clinical Trials , NIH Clinical Center for Thiopurines, Poor Metabolism of, 1

Genetic Tests for Thiopurines, Poor Metabolism of, 1

Genetic tests related to Thiopurines, Poor Metabolism of, 1:

# Genetic test Affiliating Genes
1 Poor Thiopurine Metabolism 29

Anatomical Context for Thiopurines, Poor Metabolism of, 1

MalaCards organs/tissues related to Thiopurines, Poor Metabolism of, 1:

41
Bone, Myeloid, Liver, T Cells, Bone Marrow

Publications for Thiopurines, Poor Metabolism of, 1

Articles related to Thiopurines, Poor Metabolism of, 1:

# Title Authors Year
1
Thiopurine S-methyltransferase deficiency associated with a novel mutation. ( 20186941 )
2010
2
Azathioprine-associated acute myeloid leukemia in a patient with Crohn's disease and thiopurine S-methyltransferase deficiency. ( 17696202 )
2008
3
Association of inosine triphosphatase 94C>A and thiopurine S-methyltransferase deficiency with adverse events and study drop-outs under azathioprine therapy in a prospective Crohn disease study. ( 16214825 )
2005
4
Preponderance of thiopurine S-methyltransferase deficiency and heterozygosity among patients intolerant to mercaptopurine or azathioprine. ( 11304783 )
2001
5
Allelic variants of the thiopurine S-methyltransferase deficiency in patients with ulcerative colitis and in healthy controls. ( 11007234 )
2000
6
Molecular diagnosis of thiopurine S-methyltransferase deficiency: genetic basis for azathioprine and mercaptopurine intolerance. ( 9103127 )
1997
7
Molecular diagnosis of thiopurine S-methyltransferase deficiency. ( 9412292 )
1997
8
Thiopurine S-methyltransferase deficiency: two nucleotide transitions define the most prevalent mutant allele associated with loss of catalytic activity in Caucasians. ( 8644731 )
1996

Variations for Thiopurines, Poor Metabolism of, 1

ClinVar genetic disease variations for Thiopurines, Poor Metabolism of, 1:

6 (show top 50) (show all 100)
# Gene Variation Type Significance SNP ID Assembly Location
1 TPMT NM_000367.2(TPMT): c.238G> C (p.Ala80Pro) single nucleotide variant drug response rs1800462 GRCh37 Chromosome 6, 18143955: 18143955
2 TPMT NM_000367.2(TPMT): c.238G> C (p.Ala80Pro) single nucleotide variant drug response rs1800462 GRCh38 Chromosome 6, 18143724: 18143724
3 TPMT NM_000367.4(TPMT): c.460G> A (p.Ala154Thr) single nucleotide variant other rs1800460 GRCh37 Chromosome 6, 18139228: 18139228
4 TPMT NM_000367.4(TPMT): c.460G> A (p.Ala154Thr) single nucleotide variant other rs1800460 GRCh38 Chromosome 6, 18138997: 18138997
5 TPMT NM_000367.4(TPMT): c.626-1G> A single nucleotide variant drug response rs1800584 GRCh37 Chromosome 6, 18131012: 18131012
6 TPMT NM_000367.4(TPMT): c.626-1G> A single nucleotide variant drug response rs1800584 GRCh38 Chromosome 6, 18130781: 18130781
7 TPMT NM_000367.4(TPMT): c.719A> G (p.Tyr240Cys) single nucleotide variant other rs1142345 GRCh37 Chromosome 6, 18130918: 18130918
8 TPMT NM_000367.4(TPMT): c.719A> G (p.Tyr240Cys) single nucleotide variant other rs1142345 GRCh38 Chromosome 6, 18130687: 18130687
9 TPMT NM_000367.4(TPMT): c.644G> A (p.Arg215His) single nucleotide variant drug response rs56161402 GRCh37 Chromosome 6, 18130993: 18130993
10 TPMT NM_000367.4(TPMT): c.644G> A (p.Arg215His) single nucleotide variant drug response rs56161402 GRCh38 Chromosome 6, 18130762: 18130762
11 TPMT NM_000367.4(TPMT): c.500C> G (p.Ala167Gly) single nucleotide variant drug response rs74423290 GRCh37 Chromosome 6, 18134115: 18134115
12 TPMT NM_000367.4(TPMT): c.500C> G (p.Ala167Gly) single nucleotide variant drug response rs74423290 GRCh38 Chromosome 6, 18133884: 18133884
13 TPMT NM_000367.4(TPMT): c.420-4G> A single nucleotide variant Uncertain significance rs56019966 GRCh37 Chromosome 6, 18139272: 18139272
14 TPMT NM_000367.4(TPMT): c.420-4G> A single nucleotide variant Uncertain significance rs56019966 GRCh38 Chromosome 6, 18139041: 18139041
15 TPMT NM_000367.4(TPMT): c.*1873G> A single nucleotide variant Uncertain significance rs886061255 GRCh37 Chromosome 6, 18129026: 18129026
16 TPMT NM_000367.4(TPMT): c.*1873G> A single nucleotide variant Uncertain significance rs886061255 GRCh38 Chromosome 6, 18128795: 18128795
17 TPMT NM_000367.4(TPMT): c.*1804G> T single nucleotide variant Uncertain significance rs559243767 GRCh37 Chromosome 6, 18129095: 18129095
18 TPMT NM_000367.4(TPMT): c.*1804G> T single nucleotide variant Uncertain significance rs559243767 GRCh38 Chromosome 6, 18128864: 18128864
19 TPMT NM_000367.4(TPMT): c.*1778_*1781dupAAAA duplication Uncertain significance rs886061256 GRCh37 Chromosome 6, 18129118: 18129121
20 TPMT NM_000367.4(TPMT): c.*1778_*1781dupAAAA duplication Uncertain significance rs886061256 GRCh38 Chromosome 6, 18128887: 18128890
21 TPMT NM_000367.4(TPMT): c.*1757delC deletion Uncertain significance rs748123873 GRCh37 Chromosome 6, 18129142: 18129142
22 TPMT NM_000367.4(TPMT): c.*1757delC deletion Uncertain significance rs748123873 GRCh38 Chromosome 6, 18128911: 18128911
23 TPMT NM_000367.4(TPMT): c.*1522C> T single nucleotide variant Uncertain significance rs116170115 GRCh37 Chromosome 6, 18129377: 18129377
24 TPMT NM_000367.4(TPMT): c.*1522C> T single nucleotide variant Uncertain significance rs116170115 GRCh38 Chromosome 6, 18129146: 18129146
25 TPMT NM_000367.4(TPMT): c.*1204G> A single nucleotide variant Uncertain significance rs886061260 GRCh37 Chromosome 6, 18129695: 18129695
26 TPMT NM_000367.4(TPMT): c.*1204G> A single nucleotide variant Uncertain significance rs886061260 GRCh38 Chromosome 6, 18129464: 18129464
27 TPMT NM_000367.4(TPMT): c.*523G> A single nucleotide variant Uncertain significance rs886061261 GRCh37 Chromosome 6, 18130376: 18130376
28 TPMT NM_000367.4(TPMT): c.*523G> A single nucleotide variant Uncertain significance rs886061261 GRCh38 Chromosome 6, 18130145: 18130145
29 TPMT NM_000367.4(TPMT): c.*329A> G single nucleotide variant Uncertain significance rs886061263 GRCh37 Chromosome 6, 18130570: 18130570
30 TPMT NM_000367.4(TPMT): c.*329A> G single nucleotide variant Uncertain significance rs886061263 GRCh38 Chromosome 6, 18130339: 18130339
31 TPMT NM_000367.4(TPMT): c.375G> A (p.Ser125=) single nucleotide variant Uncertain significance rs760980416 GRCh38 Chromosome 6, 18139709: 18139709
32 TPMT NM_000367.4(TPMT): c.375G> A (p.Ser125=) single nucleotide variant Uncertain significance rs760980416 GRCh37 Chromosome 6, 18139940: 18139940
33 TPMT NM_000367.4(TPMT): c.-44-4G> A single nucleotide variant Uncertain significance rs202034437 GRCh37 Chromosome 6, 18149406: 18149406
34 TPMT NM_000367.4(TPMT): c.-44-4G> A single nucleotide variant Uncertain significance rs202034437 GRCh38 Chromosome 6, 18149175: 18149175
35 TPMT NM_000367.4(TPMT): c.-66C> T single nucleotide variant Uncertain significance rs141028204 GRCh37 Chromosome 6, 18155285: 18155285
36 TPMT NM_000367.4(TPMT): c.-66C> T single nucleotide variant Uncertain significance rs141028204 GRCh38 Chromosome 6, 18155054: 18155054
37 TPMT NM_000367.4(TPMT): c.*1900A> C single nucleotide variant Likely benign rs1142378 GRCh37 Chromosome 6, 18128999: 18128999
38 TPMT NM_000367.4(TPMT): c.*1900A> C single nucleotide variant Likely benign rs1142378 GRCh38 Chromosome 6, 18128768: 18128768
39 TPMT NM_000367.4(TPMT): c.*1820A> G single nucleotide variant Uncertain significance rs1142374 GRCh37 Chromosome 6, 18129079: 18129079
40 TPMT NM_000367.4(TPMT): c.*1820A> G single nucleotide variant Uncertain significance rs1142374 GRCh38 Chromosome 6, 18128848: 18128848
41 TPMT NM_000367.4(TPMT): c.*1604G> A single nucleotide variant Likely benign rs9465100 GRCh37 Chromosome 6, 18129295: 18129295
42 TPMT NM_000367.4(TPMT): c.*1604G> A single nucleotide variant Likely benign rs9465100 GRCh38 Chromosome 6, 18129064: 18129064
43 TPMT NM_000367.4(TPMT): c.*1511G> A single nucleotide variant Uncertain significance rs553500255 GRCh37 Chromosome 6, 18129388: 18129388
44 TPMT NM_000367.4(TPMT): c.*1511G> A single nucleotide variant Uncertain significance rs553500255 GRCh38 Chromosome 6, 18129157: 18129157
45 TPMT NM_000367.4(TPMT): c.*1305C> G single nucleotide variant Uncertain significance rs144017186 GRCh37 Chromosome 6, 18129594: 18129594
46 TPMT NM_000367.4(TPMT): c.*1305C> G single nucleotide variant Uncertain significance rs144017186 GRCh38 Chromosome 6, 18129363: 18129363
47 TPMT NM_000367.4(TPMT): c.*1218G> A single nucleotide variant Uncertain significance rs186206580 GRCh37 Chromosome 6, 18129681: 18129681
48 TPMT NM_000367.4(TPMT): c.*1218G> A single nucleotide variant Uncertain significance rs186206580 GRCh38 Chromosome 6, 18129450: 18129450
49 TPMT NM_000367.4(TPMT): c.*634dupT duplication Uncertain significance rs760084154 GRCh37 Chromosome 6, 18130265: 18130265
50 TPMT NM_000367.4(TPMT): c.*634dupT duplication Uncertain significance rs760084154 GRCh38 Chromosome 6, 18130034: 18130034

Expression for Thiopurines, Poor Metabolism of, 1

Search GEO for disease gene expression data for Thiopurines, Poor Metabolism of, 1.

Pathways for Thiopurines, Poor Metabolism of, 1

Pathways related to Thiopurines, Poor Metabolism of, 1 according to KEGG:

37
# Name Kegg Source Accession
1 Drug metabolism - other enzymes hsa00983

GO Terms for Thiopurines, Poor Metabolism of, 1

Biological processes related to Thiopurines, Poor Metabolism of, 1 according to GeneCards Suite gene sharing:

# Name GO ID Score Top Affiliating Genes
1 neutrophil degranulation GO:0043312 9.33 PNP PRSS3 RAB3D
2 nucleobase-containing compound metabolic process GO:0006139 8.96 PNP TPMT
3 purine nucleotide catabolic process GO:0006195 8.8 ITPA NUDT15 PNP

Molecular functions related to Thiopurines, Poor Metabolism of, 1 according to GeneCards Suite gene sharing:

# Name GO ID Score Top Affiliating Genes
1 NADH pyrophosphatase activity GO:0035529 9.16 ITPA NUDT15
2 nucleoside-triphosphate diphosphatase activity GO:0047429 8.96 ITPA NUDT15
3 nucleotide diphosphatase activity GO:0004551 8.62 ITPA NUDT15

Sources for Thiopurines, Poor Metabolism of, 1

3 CDC
7 CNVD
9 Cosmic
10 dbSNP
11 DGIdb
17 ExPASy
19 FMA
28 GO
29 GTR
30 HGMD
31 HMDB
32 HPO
33 ICD10
34 ICD10 via Orphanet
35 ICD9CM
36 IUPHAR
37 KEGG
38 LifeMap
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42 MedGen
44 MeSH
45 MESH via Orphanet
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58 OMIM via Orphanet
62 PubMed
64 QIAGEN
69 SNOMED-CT via HPO
70 SNOMED-CT via Orphanet
71 TGDB
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74 UMLS via Orphanet
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