Mycophenolate mofetil (MMF) (brand names CellCept, Myfortic) is an immunosuppressant and prodrug of mycophenolic acid, used extensively in transplant medicine. It is a reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH) in purine biosynthesis (specifically guanine synthesis) which is necessary for the growth of T cells and B cells. Other cells are able to recover purines via a separate scavenger pathway and are thus able to escape the effect.
MMF is a less toxic alternative to azathioprine.
MMF is also used in the treatment of autoimmune diseases, such as Behçet's disease, pemphigus vulgaris, systemic lupus erythematosus and refractory incomplete lupus erythematosus. Suppressing T cells and B cells stops them from attacking healthy cells, but also weakens their ability to defend against infections.
The chemical name for mycophenolate mofetil is 2-morpholinoethyl (E)-6-(1,3-dihydro-4-hydroxy-6-methoxy-7-methyl-3-oxo-5-isobenzofuranyl)-4-methyl-4-hexenoate. Its empirical formula is C23H31NO7 and molecular weight 433.50. Mycophenolate mofetil is morpholinoethyl ester of mycophenolic acid, which is used to mask the carboxyl group. Mycophenolate mofetil is reported to have pKa values 5.6 for the morpholino moiety and 8.5 for the phenolic group.
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... The two most commonly used agents are mycophenolate mofetil and intravenous cyclophosphamide ... with Class III or IV disease are more likely to benefit from mycophenolate mofetil as compared to cyclophosphamide ... by the same authors that directly compared these therapies did not show that Mycophenolate was superiour to cyclophosphamide except in non-caucasian non-A ...
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