Inosine is commonly found in tRNAs and is essential for proper translation of the genetic code in wobble base pairs.
Knowledge of inosine metabolism has led to advances in immunotherapy in recent decades. Inosine monophosphate is oxidised by the enzyme inosine monophosphate dehydrogenase yielding xanthosine monophosphate, a key precursor in purine metabolism. Mycophenolate mofetil is an anti-metabolite, anti-proliferative drug, used in the treatment of a variety of autoimmune diseases including Wegener's granulomatosis. The uptake of purine by actively dividing B cells can exceed 8 times that of normal body cells and therefore this set of white cells (which cannot operate purine salvage pathways) is selectively targeted by the purine deficiency resulting from IMD inhibition.
Purine nucleoside phosphorylase intraconverts inosine and hypoxanthine.
Inosine is also an intermediate in a chain of purine nucleotides reactions required for muscle movements.
Nowadays, it has been shown that inosine has neuroprotective properties. It has been proposed for spinal cord injury;, because it improves axonal rewiring, and for administration after stroke, because observation has shown that axonal re-wiring is encouraged..
It is currently in phase II trials for multiple sclerosis (MS) . It produces uric acid after ingestion, which is a natural antioxidant and a peroxynitrite scavenger, which can suggest possible benefit in multiple sclerosis (peroxynitrite has been correlated with the axons degeneration
).
Alseres Pharmaceuticals (named Boston Life Sciences when patent was granted) patented the treatment for stroke
and is currently investigating the drug in the MS setting.