Folic Acid Health Article

Definition

Folic acid is a water-soluble B vitamin essential in the human diet. It is an important cofactor in the synthesis of DNA and RNA of dividing cells, particularly during pregnancy and infancy when there is an increase in cell division and growth.

Purpose

Folic acid is important to the field of oncology in two ways. First, prior to neoplasm formation, folic acid is important in the synthesis of DNA and RNA and the repair of damaged DNA. Second, after a tumor develops, a form of folic acid is used to counter the side effects of methotrexate and fluorouracil.

Description

Prior to tumor formation

Since folic acid is a cofactor in DNA replication and biosynthesis of purines and also in DNA repair, there is an increasing amount of research (epidemiological, clinical, and experimental) that suggests a folic acid deficiency might be a factor that predisposes the formation of tumors in normal epithelial tissue. There is an inverse relationship associated with low folate diets and an increase in DNA breakage and mutation that is unable to be effectively repaired. The preventative influence of dietary folic acid on the formation of colon cancer is currently under heavy research. Although a correlation is observed, it has not yet been proven to show cause and effect. However, there is enough evidence to encourage consuming minimal daily dietary requirements of folic acid to potentially reduce the risk. When choosing supplements, other names for folic acid that may be encountered are folate and folacin.

After tumors form

Once a neoplasm forms, folic acid levels need to be decreased. In neoplasms, DNA replication and cell division are both occurring in an uncontrolled manner. Folate, which assists in this process, needs to be inhibited, causing an interruption in DNA synthesis and slowing the growth of the tumor. Chemotherapeutic agents called antimetabolites, or folic acid antagonists, such as methotrexate and 5-fluorouracil (5-FU), inhibit the enzymatic pathways for biosynthesis of nucleic acids by substituting for folic acid and sabotaging the reaction. Unfortunately, drugs that inhibit the biosynthesis of cancer cells also inhibit the biosynthesis of normal cells, resulting in extremely toxic side effects. To counter the side effects, a drug called leucovorin (a form of folate also known as Wellcovorin, Citrovorum and folinic acid) opposes the toxic effects of methotrexate on normal tissue. Leucovorin also increases the anticancer effect of 5-FU.