Investigation of the Association Between Total and Free Plasma and Saliva Mycophenolic Acid Concentrations Following Administration of Enteric-Coated Mycophenolate Sodium in Adult Kidney Transplant Recipients

Personalized Therapy for Mycophenolate: Consensus Report by the International Association of Therapeutic Drug Monitoring and Clinical Toxicology

“…Some studies reported an acceptable correlation of total as well as fMPA concentrations between plasma and oral fluid concentrations, 266,267,351 whereas others found a poor correlation. 350 Therefore, the use of oral fluid for the purpose of MPA TDM cannot be recommended yet, and further studies are needed to identify the most appropriate sampling and sample pretreatment conditions.…”

“…Insufficient specimen volumes; interference from food particles, substances, and drugs, which can change the pH and the flow of the oral fluid; contamination by blood released from teeth after brushing or flossing; and the microbial flora dependent on dental hygiene can modify the actual concentration or compromise measurement accuracy. 348,350 The wide variety of specimen collection methods (with and without stimulation) and devices may also significantly contribute to result variability.…”

Clinical Value of Emerging Bioanalytical Methods for Drug Measurements: A Scoping Review of Their Applicability for Medication Adherence and Therapeutic Drug Monitoring

“…There is evidence that TDM of the following drugs is not feasible using DBS (aripiprazole, pipamperone, risperidone) [ 66 ], saliva (amisulpride, aripiprazole, lisdexamfetamine, moxifloxacin, olanzapine, oxycodone) [ 37 , 66 – 68 , 70 , 71 ], and hair (chlorpromazine, ciclosporin, erlotinib, lamotrigine) [ 29 , 45 , 69 , 72 ]. These alternative matrices could not substitute traditional blood samples for TDM purposes due to large interindividual or intraindividual variability and poor correlations [ 37 , 66 – 68 , 71 , 73 – 75 ].…”

“…There should be a good correlation between dose-dependent concentrations and clinical outcomes. Some articles described a validation for TDM that was not sufficient, as the relationship was poor due to, for example, large interindividual or intraindividual variability [ 37 , 66 – 68 , 71 , 73 – 75 ], but still recommend uisng their validated assay method for (semi-) quantitative MAM. They strongly suggest applying the matrices as qualitative adherence tools in clinical practice, for example DBS for risperidone, saliva for lisdexamfetamine [ 70 ], and hair for lamotrigine [ 45 ].…”

An Overview of Natural and Synthetic Phthalides Involved in Cancer Studies: Past, Present, and Future

“…[52] Austalide W (12) is isolated from the fungus Aspergillus ustus VKM F-4692, affecting negatively proliferation and migration of prostate and bladder cancer cells. [53] Mycophenolic acid (MPA) (13), which was isolated as a fermentation product of Penicillium stoloniferum has antifungal, antibacterial, antiviral, and immunosuppressive activities, [54,55] and its morpholino ester -mycophenolate mofetil (MMF) ( 14)is widely used in solid organ transplantation to prevent rejection [55][56][57] (Figure 3) etc. The main in vivo metabolic reactions of phthalides, [58] especially alkyl phthalides and hydroxylated phthalides, appear to be conjugation with glutathione, cysteine, glucuronic, and sulfuric acids in the dried rhizome of Ligusticun chuanxiong Hort.…”