Mycophenolate mofetil: safety and efficacy in the prophylaxis of acute kidney transplantation rejection

Abstract

Mycophenolate mofetil (MMF), a prodrug of mycophenolic acid (MPA), is an inhibitor of inosine monophosphate dehydrogenase (IMPDH). It preferentially inhibits denovo pathway of guanosine nucleotide synthesis in T and B-lymphocytes and prevents their proliferation, thereby suppresses both cell mediated and humoral immune responses. Clinical trials in kidney transplant recipients have shown the effi cacy of MMF in reducing the incidence and severity of acute rejection episodes. It also improves long term graft function as well as graft and patient survival in kidney transplant recipients. MMF is useful as a component of toxicity sparing regimens to reduce or avoid exposure of steroids or calcineurin inhibitor (CNI). Enteric-coated mycophenolate sodium (EC-MPS) can be used as an alternative immunosuppressive agent in kidney transplant recipients with effi cacy and safety profi le similar to MMF.

Kunxian Capsule for Rheumatoid Arthritis: Inhibition of Inflammatory Network and Reducing Adverse Reactions Through Drug Matching

“…maintaining cellular guanine deoxy-and ribonucleotide pools, which needed for DNA and RNA synthesis (Dalal et al, 2009). The functions of MTHFD1 have been described previously.…”

“…Hutch, i.e., IMPDH2, MTHFD1, PKD2, PTGIS, SLC25A13, AGTR1, NR0B1, AR, and AGT ( Figure 4). IMPDH2 is involved in cellular guanine metabolism, which could play a critical role in DNA and RNA synthesis (Dalal et al, 2009). MTHFD1 could encode a protein that possesses 5,10-methenyltetrahydrofolate cyclohydrolase, 5,10-methylenetetrahydrofolate dehydrogenase, and 10formyltetrahydrofolate synthetase activities.…”

“…To summarize, MTHFD1 and IMPDH2 are involved in the transcriptional synthesis of RNA and DNA. Indeed, IMPDH2 is the target of Mycophenolate mofetil (MMF) (Dalal et al, 2009), and the MTHFD1, similar to methotrexate (MTX), is associated with the metabolism of THF (de Jonge et al, 2005). It is not surprising that all the side effect, such as sperm reduction and leukopenia of MMF and MTX, overlap KX's because they shared the same mechanism.…”

Multiparametric Profiling of Neutrophil Function via a High-Throughput Flow Cytometry-Based Assay

“…We selected a panel of compounds known to influence immune function. These chemicals are inhibitors of ROS production (DPI) [38], and ectodomain shedding (TMI-005) [20], as well as two clinically relevant compounds used for immune suppression in transplant patients, mycophenolate (MPA) [39] and cyclosporine A (CSA) [40]. Treatment with compounds for one hour before C. albicans co-culture did not significantly affect neutrophil phagocytic ability.…”