Skip Navigation

This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (16)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Warrens, A.N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Warrens, A.N.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Q J Med 2000; 93: 15-20
© 2000 Association of Physicians

Reviews

The evolving role of mycophenolate mofetil in renal transplantation

A.N. Warrens

From the Division of Medicine, Imperial College School of Medicine, London, UK

Dr A.N. Warrens, Renal Unit, Imperial College School of Medicine, Hammersmith Hospital, L Block, Du Cane Road, London W12 0HS. e-mail: a.warrens@ic.ac.uk


   Pharmacology
 
Mycophenolate mofetil (MMF) is an ester prodrug with higher bioavailability than the active agent, mycophenolic acid (MPA).1 MPA inhibits inosine monophosphate (IMP) dehydrogenase, an enzyme that facilitates the conversion of IMP to xanthosine monophosphate, a precursor of guanine nucleotides. This is an important step in the de novo pathway of purine nucleotide synthesis on which lymphocytes primarily depend, unlike neutrophils, for example.2 In addition, different isoforms of IMP dehydrogenase exist, and MPA is not only almost five times more potent in inhibiting the type II isoform, that is associated with stimulated rather than resting lymphocytes,3 but is also, to some extent, cell type specific.4 Thus, on theoretical grounds, MMF represents a significant improvement on the antimetabolite azathioprine the use of which is well-established in organ transplantation.


   In vitro and animal studies
 
MMF is effective in prolonging the survival of mouse and rat cardiac allografts,5,6 showing an additive effect with cyclosporin, brequinar or tacrolimus.6–9 It can . . . [Full Text of this Article]


   Clinical experience in renal transplantation
 
Prophylaxis
Rescue therapy
Maintenance therapy

   Significance of the effect of MMF on the incidence of acute rejection
 

   Adverse effects
 

   Conclusions
 

   References
 

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Rheumatology (Oxford)Home page
C. N. Pisoni, M. J. Cuadrado, M. A. Khamashta, G. R. V. Hughes, and D. P. D'Cruz
Mycophenolate mofetil treatment in resistant myositis
Rheumatology, March 1, 2007; 46(3): 516 - 518.
[Abstract] [Full Text] [PDF]

Home page
 LupusHome page
C N Pisoni, Y Karim, and M J Cuadrado
Mycophenolate mofetil and systemic lupus erythematosus: an overview
Lupus, March 1, 2005; 14(3_suppl): s9 - s11.
[Abstract] [PDF]

Home page
 LupusHome page
M Y Karim and I C Abbs
Mycophenolate mofetil in nonlupus glomerulonephropathy
Lupus, March 1, 2005; 14(3_suppl): s39 - s41.
[Abstract] [PDF]

Home page
 LupusHome page
C. Pisoni, Y. Karim, and M. Cuadrado
Mycophenolate mofetil and systemic lupus erythematosus: an overview
Lupus, January 1, 2005; 14(1_suppl): s9 - s11.
[Abstract] [PDF]

Home page
 LupusHome page
M. Karim and I. Abbs
Mycophenolate mofetil in nonlupus glomerulonephropathy
Lupus, January 1, 2005; 14(1_suppl): s39 - s41.
[Abstract] [PDF]

Home page
 LupusHome page
Y Karim and D P D'Cruz
The NIH pulse cyclophosphamide regime: the end of an era?
Lupus, January 1, 2004; 13(1): 1 - 3.
[PDF]

Home page
 ANN INTERN MEDHome page
R. Rault
Mycophenolate-Associated Onycholysis
Ann Intern Med, December 5, 2000; 133(11): 921 - 922.
[Full Text] [PDF]