Novel therapies for sarcoidosis
Robert P Baughman1, Elyse E Lower
1Division of Pulmonary and Critical Care Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio 45267, USA. Bob.Baughman@uc.edu
Seminars in Respiratory and Critical Care Medicine
|March 3, 2007
Summary
Newer therapies for sarcoidosis offer alternatives when corticosteroids fail. This review examines immunosuppressive, cytotoxic, and immunomodulatory agents, including methotrexate and tumor necrosis factor-alpha inhibitors, for effective treatment.
Area of Science:
- Immunology
- Pulmonology
- Rheumatology
Background:
- Sarcoidosis treatment is debated, with corticosteroids as the primary therapy.
- Alternative options are needed for patients unresponsive or intolerant to corticosteroids.
Purpose of the Study:
- To review novel therapeutic options for sarcoidosis beyond corticosteroids.
- To discuss indications, efficacy, toxicity, and monitoring of these agents.
Main Methods:
- Literature review of published data on non-corticosteroid therapies for sarcoidosis.
- Focus on agents like methotrexate, leflunomide, azathioprine, antimalarials, antimicrobials, and TNF-alpha inhibitors.
Main Results:
- Methotrexate has the most extensive published data.
- Leflunomide, azathioprine, antimalarials, antimicrobials, and TNF-alpha inhibitors show promise.
- These agents provide viable options for refractory or intolerant cases.
Conclusions:
- Novel immunosuppressive, cytotoxic, and immunomodulatory agents are important for managing sarcoidosis.
- Careful consideration of efficacy, toxicity, and monitoring is crucial for these alternative therapies.
Related Concept Videos
01:27Tumor Immunotherapy
Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
01:18Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...
02:49Cancer Therapies
Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
01:26COPD: Management Using Bronchodilators and Corticosteroids
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...