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Mycophenolate properly known as mycophenolate mofa till is an immunosuppressant mycophenolate is used in lupus nephritis and his first-line diffuse systemic sclerosis but it’s also indicated for the prophylaxis of organ rejection in patients undergoing allergenic renal hepatic or cardiac transplant in transplant patients it is usually used in conjunction with
Interleukin 2 antagonists cyclosporine or tacrolimus as well as corticosteroids the active metabolite of macro phenol 8 micro phenolic acid prevents t-cell and b-cell proliferation and the production of cytotoxic t cells and antibodies thus mycophenolate causes arrest of the cells at the cell cycle because this is how t and b cells proliferate so how does
Micro phenolate actually disrupt the cell cycle well mycophenolate works by inhibiting impd hydrogenase within the mitochondria mycophenolate has a preferential inhibition to i mp d h to the rate limiting step in the de novo synthesis of guanine nucleotides from i mp in b and t-lymphocytes guanine is required in order to make dna rna and other proteins t and b
Lymphocytes require de novo production of guanine nucleotides in order to make dna and this is unlike neutrophils and other cells which can use preformed guanine release from the breakdown of preformed nucleic acids and this is called the salvage pathway thus mycophenolate is selective for lymphocytes causing arrest of the g1 checkpoint and no progression to the s
Phase where replication of dna takes place inhibition of impd h prevents t and b cell production and proliferation leading to immune suppression stopping the cell cycle important side effects of michael finley include milo suppression and this is because other blood cells use a cell cycle to proliferate and so michael finlay can also disrupt these cells leading to
Milo suppression increased risk of infection important gi symptoms include diarrhea as well another important point is that michael finley can be stopped three months prior to planned pregnancy without it causing any issues you
Transcribed from video
Mycophenolic Acid – Mycophenolate (organ transplant and DMARD) – mechanism of action, side effects By Armando Hasudungan