### MTHFD2L Gene Overview

**Gene Symbol:** MTHFD2L  
**Function:** The MTHFD2L gene encodes a bifunctional enzyme that plays a crucial role in the one-carbon metabolic cycle, specifically involved in the interconversion of tetrahydrofolate derivatives. This enzyme exhibits both methylenetetrahydrofolate dehydrogenase and methenyltetrahydrofolate cyclohydrolase activities, affecting cellular folate metabolism and contributing to the synthesis of purines and amino acids essential for DNA and RNA synthesis. 

### 1. Associated Genes
While specific associations are not detailed in the standard summaries, MTHFD2L might be functionally linked to several other genes involved in folate metabolism, such as:

- **MTHFD1**: Methylenetetrahydrofolate dehydrogenase (NADP+ dependent).
- **MTHFR**: Methylenetetrahydrofolate reductase.
- **DHFR**: Dihydrofolate reductase.
- **FOLR1**: Folate receptor 1.

These genes participate in similar biochemical pathways and processes linked to folate metabolism.

### 2. Aging and Age-Related Diseases
Research in this area is limited, but alterations in folate metabolism and its associated pathways have been implicated in the aging process and age-related diseases. Given that MTHFD2L is integral to one-carbon metabolism, it may influence:

- **Cognitive decline**: Adequate folate levels are associated with neurological health; disturbances in one-carbon metabolism can lead to homocysteine accumulation, which has been linked to cognitive impairment and dementia.
- **Cardiovascular diseases**: Aberrations in folate metabolism can be a risk factor for cardiovascular diseases due to homocysteine levels' impact on vascular integrity.
- **Cancer**: Some studies suggest that altered folate metabolism might influence cancer risk.

### 3. Drug Interactions
While specific drug interactions directly targeting MTHFD2L are not extensively characterized, general classes of drugs that may influence folate metabolism include:

- **Methotrexate**: An antifolate drug that inhibits dihydrofolate reductase, thus affecting the metabolism of folate pathways. This can indirectly impact the pathways in which MTHFD2L is involved.
- **Folic Acid Supplements**: These might enhance the pathways involving MTHFD2L by increasing the availability of folate substrates.
  
Further mechanistic studies might reveal more specific interactions, particularly in the context of drug efficacy and toxicity in relation to folate metabolism.

### 4. Pathways and Biological Processes
MTHFD2L is involved in multiple key biochemical pathways, including:

- **One-Carbon Metabolism Pathway**: Crucial for the synthesis of nucleotides and amino acids.
- **Tetrahydrofolate Interconversion**: Involvement in the metabolism of folate derivatives, important for various metabolic processes, including DNA synthesis.
- **Purine and Pyrimidine Synthesis**: Folate derivatives participate in the biosynthesis of these nucleotides.

Further studies on MTHFD2L may elucidate its specific roles in these pathways and how it might be targeted for therapeutic intervention in related disorders.