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L18-MDP is a synthetic, lipophilic derivative of muramyl dipeptide (MDP) in which the C6 hydroxyl group of MDP is esterified with stearic acid, enhancing its cell permeability and potency as an immunomodulator[1][2][4][5][7]. L18-MDP acts as a potent agonist of the cytosolic pattern recognition receptor NOD2, activating innate immune pathways mainly through MAPK and NF-κB signaling, and triggers strong pro-inflammatory cytokine release[1][7]. It has demonstrated enhanced protection against bacterial and viral infections in animal models, and has been evaluated for malignant pleurisy associated with lung cancer[2][3][4][5].
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