Resolution Pharmacology Targeting the Melanocortin System

The simple but profound conceptual change in our understanding of how inflammation is terminated resulted in the emergence of a new field of research offering new opportunities for drug development. The realisation that inflammation is terminated through the orchestration of coordinated cellular and molecular responses shifted the efforts in the search for new medicines to target chronic inflammation towards the exploitation of our body's own pro-resolving mechanisms. The melanocortin system, a pro-resolving system formed by a family of five G-protein-coupled receptors and a series of endogenous peptides, is a candidate under intense efforts for the development of new drugs for the treatment of conditions like rheumatoid arthritis, scleroderma, and others with underlying chronic inflammation. Indeed, several melanocortin drugs have already reached regulatory approval and are currently used in patients. Here we describe the therapeutic potential of targeting the melanocortin system and its role in the resolution of inflammation, we summarise the developmental efforts to generate improved molecules, and we analyse the areas requiring further development in order to keep progressing into novel medicines.