Macrolide immunosuppressants

Macrolide immunosuppressants are a new class of compounds sharing a macrolide-like structure and potent immunosuppressive activity in vitro and in vivo. Tacrolimus, the best known substance of this group, is registered in many countries for the prevention of transplant rejection. Numerous new substances of this group are in the pipelines of the pharmaceutical industries. Macrolide immunosuppressants are also effective in dermatological disorders. Due to their chemical structure these compounds can be used for topical treatment. Clinical studies have already shown highly effective topical therapy of atopic dermatitis with tacrolimus and the ascomycin derivative SDZ ASM 981, another macrolide immunosuppressant. In this article the pharmacological aspects of macrolide immunosuppressants, their supposed mechanisms of action, pre-clinical and clinical experience are reviewed.