Mycophenolic acid

So therefore, if someone's predominant feature when they attend us, like lupus or Sjogren's is is inflammation in their joints will go with methotrexate.

Similarly, we know that the Cellcept is really good for kidney disease and kidney disease has been used in the transplant literature.

So we've borrowed that from our friends in nephrology and we use that in kidney disease.

And then I suppose the final thing to mention is that there are additional treatments beyond the conventional disease modifying therapies or DMARD.

The clinical data explicitly notes that fifty percent of patients get early profuse diarrhea accompanied by high white blood cell counts without a left shift, and they are usually completely afebrile.

Mycophenolate is highly effective at suppressing T cell proliferation by denying them purines.

However, the epithelial cells lining the entire gastrointestinal tract also divide incredibly rapidly to maintain the mucosal barrier.

The drug starves them just as effectively.

And so there is a need to be able to get a trough and then a peak and then a one hour and three hour level to be able to get a better sense of what the AUC is.

Mycophenolate itself, since it's extremely highly protein bound, would be unlikely to be removed by dialysis.

However, there are data in the phoresis population, which is certainly very relevant for our patients who are getting phoresis for treatment of antibody-mediated rejection, for example, that 25 to 30% of the mycophenolate may be removed if the mycophenolate is given within an hour or two of the phoresis session.

So it's something to consider.

What was the thing that they tried? If you don't mind me asking.

It was a mix of a type of chemotherapy and a medication called CellCept, which is something they give to people who are going to get an organ transplant so that their immune systems don't reject the organ.

His theory was that my immune system was killing me, it was attacking itself, that if he shut my immune system down, maybe that would fix the problem.

'Cause he's like, "You don't have an autoimmune disease.

Tysabri's pulled from the market.

Then I've switched to CellCept.

And then I'm like, okay, I know how bad this is gonna be, really terrible, and I go back to reading the basic science.

And I eventually decide that, and mind you, no one's yet talking about mitochondria in the MS community.