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INTRODUCTION Methotrexate (MTX) is a synthetic antimetabolite with many therapeutic indications, mainly anti-inflammatory and immunosuppressant at relatively low doses and antineoplastic at high doses.[ , ] MTX competitively inhibits dihydrofolate reductase, so decreasing tetrahydrofolate level leads to blocks the synthesis of purines, pyrimidines, DNA, ribonucleic acid, thymidylate, and proteins.[ , , ] It is well known that MTX is a hepatotoxic drug, and this leads to limitation of its clinical use

Lancet Respir Med 2021

However, despite the fact that many experiments have shown statistically significant geroprotective and neuroendocrine effects of Epitalon, resulting from its antioxidant, neuroprotective, and antimutagenic effects, its mechanism of action remains unclear

From this point of view, it could be hypothesized that persistent virus infections may have a more significant impact on the exo-RNAi pathway, e.g