Dimethyl fumarate

Dimethyl fumarate is a lipophilic electrophile that has profound effects on oxidative and immunological pathways.{23442} It rapidly interacts in a Michael addition reaction with glutathione or is metabolized to monomethyl fumarate.{23442} Dimethyl fumarate at low micromolar levels activates the nuclear factor erythroid 2-related factor 2 (Nrf2), resulting in an antioxidant response featuring heme oxygenase-1 expression and increased glutathione levels.{23442} It also suppresses the expression of pro-inflammatory cytokines and inhibits angiogenesis.{23440,23439} Through these actions dimethyl fumarate alters the course of psoriasis and may reduce inflammation related to multiple sclerosis.{23440,23441}