9-羧基甲氧基甲基鳥嘌呤

**9-羧基甲氧基甲基鳥嘌呤**
識別資訊
	IUPAC命名法 2-[(2-Amino-6-oxo-3H-purin-9-yl)methoxy]acetic acid; ;
CAS號	80685-22-9
PubChem CID	133521;
ChemSpider	117782;
UNII	N28227W35C;
CompTox Dashboard（英語：CompTox Chemicals Dashboard） (EPA)	DTXSID40230501 ;
化學資訊
化學式	C8H9N5O4
摩爾質量	239.19 g·mol−1
3D模型（JSmol（英語：JSmol））	交互式圖像;
	SMILES C1=NC2=C(N1COCC(=O)O)N=C(NC2=O)N;
	InChI InChI=1S/C8H9N5O4/c9-8-11-6-5(7(16)12-8)10-2-13(6)3-17-1-4(14)15/h2H,1,3H2,(H,14,15)(H3,9,11,12,16); Key:MICNQLKUSOVNNG-UHFFFAOYSA-N;

9-羧基甲氧基甲基鳥嘌呤（英語：9-Carboxymethoxymethylguanine），簡稱CMMG，是一種化合物，被認為抗病毒藥物阿昔洛韋（及其前藥伐昔洛韋）的主要代謝物，並被認為是有時與這些藥物相關的神經精神副作用的致病因子。這些主要由腎功能衰竭或腎功能下降的患者遭受，並且可能包括精神病性反應、幻覺和罕見的更複雜的疾病，如科塔爾綜合症。研究發現接受阿昔洛韋治療後出現這些症狀的患者的CMMG水平比正常人高得多。由於這是科塔爾綜合症首次與藥物副作用相關聯，這一發現可能有助於科塔爾綜合症的研究及其治療。^[1]^[2]^[3]^[4]^[5]^[6]

參考資料

^ Svensson JO, Barkholt L, Säwe J. Determination of acyclovir and its metabolite 9-carboxymethoxymethylguanine in serum and urine using solid-phase extraction and high-performance liquid chromatography. Journal of Chromatography. B, Biomedical Sciences and Applications. March 1997, 690 (1–2): 363–6. PMID 9106067. doi:10.1016/S0378-4347(96)00424-0.
^ Helldén A, Odar-Cederlöf I, Diener P, Barkholt L, Medin C, Svensson JO, et al. High serum concentrations of the acyclovir main metabolite 9-carboxymethoxymethylguanine in renal failure patients with acyclovir-related neuropsychiatric side effects: an observational study. Nephrology, Dialysis, Transplantation. June 2003, 18 (6): 1135–41. PMID 12748346. doi:10.1093/ndt/gfg119 .
^ Helldén A, Odar-Cederlöf I, Larsson K, Fehrman-Ekholm I, Lindén T. Death delusion. BMJ. December 2007, 335 (7633): 1305. PMC 2151143 . PMID 18156240. doi:10.1136/bmj.39408.393137.BE.
^ Ruiz-Roso G, Gomis A, Fernández-Lucas M, Díaz-Domínguez M, Teruel-Briones JL, Quereda C. Aciclovir and valaciclovir neurotoxicity in patients with renal failure. Nefrologia. 2012, 32 (1): 114–5. PMID 22294022. doi:10.3265/Nefrologia.pre2011.Nov.11247.
^ Lindén, T.; Helldén, A. Cotard's syndrome as an adverse effect of acyclovir treatment in renal failure. Journal of the Neurological Sciences. 2013, 333: e650. S2CID 54428588. doi:10.1016/j.jns.2013.07.2255.
^ Saul H. Reversing walking corpse syndrome: Cotard's Syndrome trigger found - and it's a household cold sore cream.. The Independent. 18 October 2013 [2023-04-20]. （原始內容存檔於2015-09-25）.

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[1] Svensson JO, Barkholt L, Säwe J. Determination of acyclovir and its metabolite 9-carboxymethoxymethylguanine in serum and urine using solid-phase extraction and high-performance liquid chromatography. Journal of Chromatography. B, Biomedical Sciences and Applications. March 1997, 690 (1–2): 363–6. PMID 9106067. doi:10.1016/S0378-4347(96)00424-0.

[2] Helldén A, Odar-Cederlöf I, Diener P, Barkholt L, Medin C, Svensson JO, et al. High serum concentrations of the acyclovir main metabolite 9-carboxymethoxymethylguanine in renal failure patients with acyclovir-related neuropsychiatric side effects: an observational study. Nephrology, Dialysis, Transplantation. June 2003, 18 (6): 1135–41. PMID 12748346. doi:10.1093/ndt/gfg119 .

[3] Helldén A, Odar-Cederlöf I, Larsson K, Fehrman-Ekholm I, Lindén T. Death delusion. BMJ. December 2007, 335 (7633): 1305. PMC 2151143 . PMID 18156240. doi:10.1136/bmj.39408.393137.BE.

[4] Ruiz-Roso G, Gomis A, Fernández-Lucas M, Díaz-Domínguez M, Teruel-Briones JL, Quereda C. Aciclovir and valaciclovir neurotoxicity in patients with renal failure. Nefrologia. 2012, 32 (1): 114–5. PMID 22294022. doi:10.3265/Nefrologia.pre2011.Nov.11247.

[5] Lindén, T.; Helldén, A. Cotard's syndrome as an adverse effect of acyclovir treatment in renal failure. Journal of the Neurological Sciences. 2013, 333: e650. S2CID 54428588. doi:10.1016/j.jns.2013.07.2255.

[6] Saul H. Reversing walking corpse syndrome: Cotard's Syndrome trigger found - and it's a household cold sore cream.. The Independent. 18 October 2013 [2023-04-20]. （原始內容存檔於2015-09-25）.

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