Hackl, Agnes, Ehren, Rasmus and Weber, Lutz Thorsten (2017). Effect of mycophenolic acid in experimental, nontransplant glomerular diseases: new mechanisms beyond immune cells. Pediatr. Nephrol., 32 (8). S. 1315 - 1323. NEW YORK: SPRINGER. ISSN 1432-198X

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Abstract

Mycophenolic acid (MPA) was introduced into clinical practice as immunosuppressive drug therapy to prevent allograft rejection. Since then, its clinical application has widened. Our goal was to review the lessons learned from experimental nontransplant glomerular disease models on the mechanisms of MPA therapy. T and B lymphocytes are preferentially dependent on de novo purine synthesis. By inhibiting the rate-limiting enzyme of de novo purine synthesis, MPA depletes the pool of deoxyguanosine triphosphate (dGTP) and inhibits proliferation of these immune cells. Furthermore, MPA can also induce apoptosis of immune cells and is known to inhibit synthesis of fucose- and mannose-containing membrane glycoproteins altering the surface expression and binding ability of adhesion molecules. However, MPA exerts a direct effect also on nonimmune cells. Mesangial cells are partially dependent on de novo purine biosynthesis and are thus susceptible to MPA treatment. Additionally, MPA can inhibit apoptosis in podocytes and seems to be beneficial in preserving the expression of nephrin and podocin, and by attenuation of urokinase receptor expression leads to decreased foot-process effacement. In summary, our manuscript sheds light on the molecular mechanisms underlying the antiproteinuric effect of MPA. Overall, MPA is an excellent treatment option in many immunologic glomerulopathies because it possesses immunosuppressive properties, has a remarkable effect on nonimmune cells and counteracts the proliferation of mesangial cells, expansion of mesangial matrix, and foot-process effacement of podocytes combined with a low systemic toxicity.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Hackl, AgnesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ehren, RasmusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weber, Lutz ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-224546
DOI: 10.1007/s00467-016-3437-y
Journal or Publication Title: Pediatr. Nephrol.
Volume: 32
Number: 8
Page Range: S. 1315 - 1323
Date: 2017
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1432-198X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
TUBULAR EPITHELIAL-CELLS; MOFETIL PREVENTS; LUPUS NEPHRITIS; MESENCHYMAL TRANSITION; ADHESION MOLECULES; INDUCED EXPRESSION; NEPHROTIC SYNDROME; ENDOTHELIAL-CELLS; RENAL INJURY; KAPPA-BMultiple languages
Pediatrics; Urology & NephrologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/22454

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