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MDP-Lys(L18); Romurtide; muroctasin; romurutide; Nalpha-(N-Acetylmuramoyl-L-alanyl-D-isoglutaminyl)-Nepsilon-stearoyl-L-lysine; N2-[N2-[N-(N-Acetylmuramoyl)-L-alanyl]-D-alpha-glutaminyl]-N6-(1-octadecanoyl)-L-lysine; 2-Acetamido-3-O-[(R)-1-[[(S)-1-[[(R)-1-carbamoyl-3-[[(S)-1-carboxy-5-stearamidopentyl]c
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Romurtide is used as a hematopoietic agent for restoration of leukopenia in cancer patients treated with radiotherapy and chemotherapy (see also: hematopoiesis).
Romurtide is a synthetic muramyl dipeptide (MDP) derivative that is a potent inducer of cytokines. It is an MDP derivative, MDP-Lys(L18) = N-alpha-(N-acetylmuramyl-L-alanyl-D-isoglutaminyl)-N epsilon-stearoyl-L-lysine), called also Muroctasin. It promotes megakaryocytopoiesis through stimulation of cytokine production and accelerates peripheral platelet recovery in nonhuman primate chemotherapy model.
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Romurtide given subcutaneously elevated significantly the peripheral platelet counts during both early initiation and later recovery phase of thrombocytopenia, thereby shortening the time required for recovery to a normal platelet level and the duration of thrombocytopenia. An oral administration of romurtide was also found to have a similar therapeutic efficacy to subcutaneous administration. These results demonstrated a possible therapeutic potential of romurtide in the management of thrombocytopenia associated with myelosuppression.

Romurtide given orally enhanced the nonspecific resistance against microbial infections and hematopoiesis up to the levels achieved by subcutaneous (s.c.) injection of the compound in mice. Oral romurtide conferred protection and, in consequence, enhanced therapeutic efficacy of antibiotics against systemic infections in mice. The leukocytosis followed by the elevations of colony stimulating activity in serum and the colony forming unit of granulocyte-macrophage (c.f.u.-GM) in femoral bone marrow was observed as successive event in mice treated orally with romurtide. To obtain a comparable potency to s.c. injection of the compound at a dose of 0.1 mg per mouse, oral application required doses of 3 and 10 mg per mouse for stimulating the nonspecific resistance to infection and hematopoiesis, respectively.

Namba, K., Nakajima, R., Otani, T., & Azuma, I. (1996). Oral application of romurtide, a synthetic muramyl dipeptide derivative, stimulates nonspecific resistance to microbial infections and hematopoiesis in mice. Vaccine, 14(12), 1149-1153.

We investigated the synergistic effects of romurtide (MDP-Lys [L18]) and cefmenoxime (CMX) in the treatment of experimental Klebsiella pneumonia in mice. Mice were infected with 1 x 10(4) CFU of Klebsiella pneumoniae by inhalation of aerosol bacterial suspension. About 90% of untreated animals died within a week; however, the mortality rate of animals treated with CMX alone at a dose of 40 mg/kg/day was 60% at 7 days after the infection. When one or two doses of L18 were administered before or after the infection concomitantly with CMX, a remarkable improvement in the survival rate was observed. There was no significant improvement in the survival rate of animals treated with L18 alone before or after infection. Histopathological sections of the lungs of mice treated with CMX and L18 showed slower progression of infection than those of mice treated with CMX alone. Significant differences were also found in quantitative cultures of viable bacteria in the lungs 1 to 4 days after the infection. Although viable bacterial counts in the lungs of the control and CMX-treated groups showed a rapid increase 24 to 48 h after the infection, they remained lower than the initial counts (x 10(4)) in the lungs of mice treated with combination regimens. From these results, it can be concluded that L18 is a useful biological response modifier in the treatment of acute pulmonary bacterial infections.

Tatara, O. S. A. M. U., Nakahama, C. H. I. K. A. R. A., & Niki, Y. O. S. H. I. H. I. T. O. (1992). Synergistic effects of romurtide and cefmenoxime against experimental Klebsiella pneumonia in mice. Antimicrobial agents and chemotherapy, 36(1), 167-171.

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