Cited by 480Renal Transplantation Outcomes and TreatmentsSystemic Lupus Erythematosus ResearchBiochemical and Molecular Research

Mechanisms of action of mycophenolate mofetil

Allison, AC·2005·Lupus

Abstract

Mycophenolate mofetil (MMF, CellCept®) is a prodrug of mycophenolic acid (MPA), an inhibitor of inosine-5′‘monophosphate dehydrogenase. MPA depletes guanosine nucleotides preferentially in T and B lymphocytes and inhibits their proliferation, thereby suppressing cell-mediated immune responses and antibody formation. MPA also inhibits the glycosylation and expression of adhesion molecules, and the recruitment of lymphocytes and monocytes into sites of inflammation. MPA depletes tetrahydrobiopterin and decreases the production of nitric oxide by inducible NO synthase without affecting the activity of constitutive NO synthases. Activated macrophages produce NO and superoxide, which combine to generate tissue-damaging peroxynitrite. By these two mechanisms MMF exerts anti-inflammatory activity. Unlike calcineurin inhibitors, MMF is not nephrotoxic and does not induce the production of TGF β, which is fibrogenic. MMF does not increase blood pressure, cholesterol levels or triglyceride levels in recipients. MMF reduces acute and chronic rejection in allograft recipients and is efficacious in some nephropathies. Evidence is accumulating that MMF may have clinical utility in some autoimmune disorders.

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Crossref · 10.1177/096120330501400102

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48 of 48 references verified0 citation errors · 0 not checkable

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Authors
Allison, A.
Affiliations
SurroMed, Inc., Menlo Park, CA, USA
Venue
Lupus
Published
2005-01
Volume
14
Issue
1_suppl
Pages
2-8
ISSN
  • 0961-2033 (ISSN-L)
  • 1477-0962
OpenAlex
W2074604840
Cited by
480
References
48
Citations by year
2026: 24 · 2025: 35 · 2024: 42 · 2023: 38 · 2022: 56 · 2021: 42 · 2020: 30 · 2019: 18 · 2018: 17 · 2017: 21 · 2016: 23 · 2015: 12 · 2014: 7 · 2013: 16 · 2012: 13
FWCI
7.65
Type
journal article
Language
en
Open access
closed
Locations
  • Lupus (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
  • Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Biochemical and Molecular Research
Keywords
mycophenolate mofetil, mycophenolic acid, adhesion molecule expression, tetrahydrobiopterin, nitric oxide, inducible nitric oxide synthase, peroxynitrite, macrophages, anti-inflammatory activity, calcineurin inhibitors, allograft rejection, kidney disease, autoimmune disease, immunosuppression
MeSH terms
Azathioprine, B-Lymphocytes, Humans, Immunosuppressive Agents, Mycophenolic Acid, Nitric Oxide, T-Lymphocytes, Vascular Diseases, Cytokines

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