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

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Mechanisms of action of mycophenolate mofetil

Allison, AC·2005·Lupus

DOI 10.1177/096120330501400102

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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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Authors: Allison, A.
Affiliations: SurroMed, Inc., Menlo Park, CA, USA
Venue: Lupus
Publisher: SAGE Publications
Published: 2005-01
Volume: 14
Issue: 1_suppl
Pages: 2-8
ISSN: 0961-2033 (ISSN-L)
1477-0962
DOI: 10.1177/096120330501400102
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
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
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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Mechanisms of action of mycophenolate mofetil

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