| Dimethyl fumarate (DMF) is an important oral treatment option for various autoimmune
diseases, such as multiple sclerosis (MS) and psoriasis. DMF and its dynamic metabolite,
monomethyl fumarate (MMF) are the major compounds that exert therapeutic effects on
several pathologic conditions in part, through downregulation of immune responses. The
exact mechanism of DMF is yet to be fully understood even though its beneficial effects
on the immune system are extensively studied. It has been shown that DMF/MMF can
affect various immune cells, which can get involved in both the naive and adaptive
immune systems, such as T cells, B cells, dendritic cells, macrophages, neutrophils, and
natural killer cells. It is suggested that DMF/MMF may exert their effect on immune cells
through inhibition of nuclear factor‐κB translocation, upregulation of nuclear factor
erythroid‐derived 2(E2)‐related factor antioxidant pathway, and activation of hydroxyl
carboxylic acid receptor 2. In this review, the mechanisms underlying the modulatory
functions of DMF or MMF on the main immune cell populations involved in the
immunopathogenesis of MS are discussed. |