DMF

From WikiMD's medical encyclopedia

Dimethyl fumarate (DMF) is an organic compound with the formula (CH₃O₂C)₂C=CH₂. It is the methyl ester of fumaric acid. DMF is used in the treatment of multiple sclerosis (MS) and psoriasis. It is known for its immunomodulatory and anti-inflammatory properties.

Medical Uses

Multiple Sclerosis

Dimethyl fumarate is approved for the treatment of relapsing-remitting multiple sclerosis (RRMS). It is believed to work by activating the Nrf2 pathway, which helps protect against oxidative stress and inflammation. Clinical trials have shown that DMF can reduce the frequency of relapses and slow the progression of disability in patients with RRMS.

Psoriasis

DMF is also used in the treatment of psoriasis, a chronic autoimmune skin disease. It helps to reduce the symptoms of psoriasis by modulating the immune system and reducing inflammation.

Mechanism of Action

The exact mechanism of action of DMF is not fully understood. However, it is known to activate the Nrf2 pathway, which leads to the expression of antioxidant proteins that protect against oxidative damage triggered by injury and inflammation. DMF also has immunomodulatory effects, which help in reducing the activity of the immune system that attacks the body's own tissues in autoimmune diseases.

Side Effects

Common side effects of DMF include flushing, gastrointestinal issues such as diarrhea, nausea, and abdominal pain. More serious side effects can include lymphopenia (a reduction in white blood cells) and progressive multifocal leukoencephalopathy (PML), a rare but serious brain infection.

Chemistry

Dimethyl fumarate is a methyl ester of fumaric acid. It is a white crystalline powder that is soluble in organic solvents. The chemical structure of DMF includes two ester groups attached to a central carbon-carbon double bond.

History

DMF was first synthesized in the early 20th century. It was initially used as a fungicide and later found to have therapeutic effects in the treatment of psoriasis. In 2013, DMF was approved by the U.S. Food and Drug Administration (FDA) for the treatment of relapsing forms of multiple sclerosis.

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Contributors: Prab R. Tumpati, MD