title: A short story of anti-rheumatic therapy. VIII. The immunodepressants.
abstract: The use of immunosuppressive drugs in rheumatology is fairly recent, starting just after the Second World War with the introduction of the first alkylating agents in oncohematology. When it became clear that some rheumatic diseases, particularly rheumatoid arthritis and systemic lupus erythematosus, showed an immune-mediated pathogenesis, including proliferation of immunocompetent cells, an application was soon found for immunosuppressive drugs in their treatment. This review outlines the historical milestones that led to the current use of drugs belonging to the major groups of immunosuppressants, i.e. alkylating agents (cyclophosphamide), folic acid (methotrexate) and purine (azathioprine) antagonists. We will also talk about the history of cyclosporin A, the first "selective" immunosuppressive agent, and that of some immunoactive drugs used more recently in rheumatology, such as mycophenolate mofetil, dapson and thalidomide, is briefly described.
authors.affiliation: Università di Pisa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Pasero
authors.forename: P
authors.initials: P
authors.lastname: Marson
mesh_terms: D000477:Alkylating Agents / Q000266:history / Q000627:therapeutic use; D000486:Allergy and Immunology / Q000266:history*; D000963:Antimetabolites / Q000266:history / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000266:history* / Q000627:therapeutic use; D016572:Cyclosporine / Q000266:history / Q000627:therapeutic use; D005493:Folic Acid Antagonists / Q000266:history / Q000627:therapeutic use; D006084:Graft Rejection / Q000517:prevention & control; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007166:Immunosuppressive Agents / Q000145:classification / Q000266:history* / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000266:history / Q000627:therapeutic use; D012216:Rheumatic Diseases / Q000188:drug therapy*; D013792:Thalidomide / Q000009:adverse effects / Q000266:history / Q000627:therapeutic use
chemical_list: D000477:Alkylating Agents; D000963:Antimetabolites; D018501:Antirheumatic Agents; D005493:Folic Acid Antagonists; D007166:Immunosuppressive Agents; D013792:Thalidomide; D016572:Cyclosporine; D009173:Mycophenolic Acid