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Threonyl muramyl dipeptide (t-MDP) is a synthetic analog of muramyl dipeptide (MDP), which itself is the minimal immunologically active component of bacterial peptidoglycan. In t-MDP, the L-alanine residue of MDP is replaced by L-threonine. Like other muramyl peptides, t-MDP acts as an agonist for the intracellular pattern recognition receptor nucleotide-binding oligomerization domain 2 (NOD2), leading to activation of innate immune responses including upregulation of pro-inflammatory cytokines and stimulation of both humoral and cellular immunity[7][9]. Threonyl muramyl dipeptide has been investigated as an immunomodulator and adjuvant in cancer therapy and for its potential use in treating or preventing immune-related diseases such as inflammatory skin conditions[3][4][9]. Its activity profile suggests it may have lower potency than canonical MDP but retains adjuvant properties[9].
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