Hodge E E
Department of Urology, Cleveland Clinic Foundation, OH 44195, USA.
World J Urol. 1996;14(4):249-55. doi: 10.1007/BF00182076.
Mycophenolate mofetil (MM) is the ester derivative of mycophenolic acid (MPA), which exerts immunosuppressive activity by inhibiting de novo purine biosynthesis. Following animal models and pilot studies in human renal allograft recipients that confirmed MM's ability to prevent and half rejection episodes, 3 large multicenter studies of 500 patients each were conducted in North America, Europe, and Australia to compare MM with azathioprine or placebo, all drugs being used in conjunction with prednisone and cyclosporine. The results demonstrated a statistically significant reduction in episodes of allograft rejection in the MM groups with a concomitant reduction in the use of antirejection therapy, especially antilymphocyte antibody therapy. Adverse-event profiles were similar for all groups, although there were slightly more gastrointestinal and tissue-invasive cytomegalovirus (CMV) episodes in the MM groups. It is concluded that MM, which recently received Food and Drug Administration (FDA) approval in the United States, should be an important addition to the transplant physician's immunosuppressive armamentarium.
霉酚酸酯（MM）是霉酚酸（MPA）的酯衍生物，它通过抑制嘌呤从头合成发挥免疫抑制活性。在动物模型以及对人类肾移植受者的初步研究证实MM具有预防和减少排斥反应发作的能力之后，在北美、欧洲和澳大利亚开展了3项大型多中心研究，每项研究有500名患者，以比较MM与硫唑嘌呤或安慰剂，所有药物均与泼尼松和环孢素联合使用。结果显示，MM组的移植排斥反应发作在统计学上显著减少，同时抗排斥治疗的使用也有所减少，尤其是抗淋巴细胞抗体治疗。所有组的不良事件情况相似，尽管MM组的胃肠道和组织侵袭性巨细胞病毒（CMV）发作略多一些。得出的结论是，最近在美国获得食品药品监督管理局（FDA）批准的MM，应成为移植医生免疫抑制药库中的一项重要补充药物。
