“…Dihydrofolate reductase (DHFR), which is encoded by the dhfr gene (28), reduces dihydrofolate to tetrahydrofolate, an essential cofactor in the synthesis of nucleic acids and methionine. Mutations at amino acid positions 50, 51, 59, 108, and 164 of DHFR are implicated in pyrimethamine resistance (31)(32)(33)(34)(35). A Ser-to-Asn substitution at position 108 (CNCNI, where letters indicate amino acid positions 50, 51, 59, 108, and 164, and the altered residues are underlined) is the first step for acquiring increased resistance.…”