mykofenolihappo

Mykofenolihappo, known in English as mycophenolic acid (MPA), is a natural product produced by certain fungi, including Penicillium and related species. In medicine it is used as an immunosuppressant. The active form inhibits inosine monophosphate dehydrogenase (IMPDH), the key enzyme in de novo synthesis of guanine nucleotides. By blocking this pathway, MPA preferentially impairs lymphocyte proliferation, since these cells rely on de novo purine synthesis for growth.

In clinical use, mycophenolic acid is administered either directly or as mycophenolate mofetil (MMF), a prodrug that is rapidly converted to MPA after absorption. MMF is commonly prescribed to prevent organ transplant rejection, most notably in kidney transplantation, and is often used in combination with calcineurin inhibitors and corticosteroids. It is also employed in the management of certain autoimmune diseases, including lupus nephritis and other immune-mediated conditions.

Pharmacokinetics: MPA is variably absorbed, with MMF increasing bioavailability compared with oral MPA. It undergoes extensive hepatic glucuronidation to MPAG and other metabolites and is excreted mainly by the kidneys. Absorption can be influenced by concomitant antacids or iron supplements, and interactions with other immunosuppressants, such as cyclosporine or tacrolimus, can alter exposure.

Safety and monitoring: Common adverse effects include gastrointestinal symptoms such as diarrhea, nausea, leukopenia, infections, and hypertension. MPA is teratogenic and contraindicated during pregnancy. Monitoring typically includes regular blood counts and liver function tests, with dose adjustments as needed.