L'acido micofenolico in reumatologia

Meccanismi d'azione ed eventi avversi gravi

Translated title of the contribution: Mycophenolic acid in Rheumatology: Mechanisms of action and severe adverse events

G. Zizzo, M. de Santis, G. F. Ferraccioli

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Mycophenolic acid (MPA) is an immunosuppressive agent, more and more extensively used in transplantation, rheumatology and nephrology. In this review, we will analyze the molecular mechanisms of its action, including the newest insights, in particular the inhibition of lymphocytes and the induction of tolerogenic dendritic cells (DCs) and its direct effects on non-immune cells (fibroblasts and myofibroblasts, mesangial cells, vascular smooth muscle cells [VSMC], endothelial cells). The latters suggest new therapeutic indications, specifically fibrosis (i.e. glomerulosclerosis and interstitial lung diseases), vascular damage and pulmonary hypertension, which represent key pathogenic features in connective tissue diseases. Given the differences in sensitivity to MPA among the various cell types and the great inter-individual variability in MPA pharmacokinetics, adequate daily doses and therapeutic drug monitoring may be decisive to ensure those MPA concentrations needed to switch off inflammation and restore peripheral tolerance in autoimmune disease (AID) patients. A warning on the severe adverse events strictly linked to immune suppression (i.e. progressive multifocal leukoencephalopathy [PML]) will be stressed.

Original languageItalian
Pages (from-to)91-100
Number of pages10
JournalReumatismo
Volume62
Issue number2
Publication statusPublished - Jun 2010

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Mycophenolic Acid
Rheumatology
Peripheral Tolerance
Progressive Multifocal Leukoencephalopathy
Connective Tissue Diseases
Mesangial Cells
Nephrology
Myofibroblasts
Drug Monitoring
Interstitial Lung Diseases
Immunosuppressive Agents
Vascular Smooth Muscle
Pulmonary Hypertension
Dendritic Cells
Autoimmune Diseases
Smooth Muscle Myocytes
Blood Vessels
Fibrosis
Endothelial Cells
Pharmacokinetics

ASJC Scopus subject areas

  • Rheumatology
  • Medicine(all)

Cite this

L'acido micofenolico in reumatologia : Meccanismi d'azione ed eventi avversi gravi. / Zizzo, G.; de Santis, M.; Ferraccioli, G. F.

In: Reumatismo, Vol. 62, No. 2, 06.2010, p. 91-100.

Research output: Contribution to journalArticle

Zizzo, G. ; de Santis, M. ; Ferraccioli, G. F. / L'acido micofenolico in reumatologia : Meccanismi d'azione ed eventi avversi gravi. In: Reumatismo. 2010 ; Vol. 62, No. 2. pp. 91-100.
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