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7,8-dihydro-8-oxoguanine triphosphatase, commonly known as MTH1 (MutT homolog 1), is a key enzyme in the Nudix hydrolase family responsible for sanitizing the cellular nucleotide pool [8, 10]. It functions by hydrolyzing oxidized purine nucleoside triphosphates, such as 8-oxo-dGTP and 2-hydroxy-dATP, into their corresponding monophosphates, thereby preventing their misincorporation into DNA during replication [8, 12]. This activity is crucial for maintaining genomic stability, as the incorporation of oxidized nucleotides can lead to transversion mutations and double-strand breaks [12, 17]. In cancer biology, MTH1 is frequently overexpressed to help malignant cells survive the high levels of reactive oxygen species (ROS) generated by their accelerated metabolism and oncogenic signaling [1, 3, 9]. Consequently, MTH1 has emerged as a promising therapeutic target, with inhibitors designed to induce lethal DNA damage specifically in cancer cells while sparing normal cells that have lower oxidative stress [1, 4]. Clinical-stage inhibitors like karonudib (TH1579) are being investigated for their ability to exploit this vulnerability, often in combination with other DNA-damaging agents or antimitotics [2, 6, 11].
Inhibition of MTH1 prevents the clearance of oxidized nucleotides from the dNTP pool, leading to their incorporation into DNA, which causes genomic instability, DNA damage, and apoptosis in cancer cells [1, 3, 4].
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