Thalidomide is a drug with interesting therapeutic properties but also with severe
side effects which require a careful and monitored use. Potential immunomodulatory, antiinflammatory,
anti-angiogenic and sedative properties make thalidomide a good candidate for
the treatment of several diseases such as multiple myeloma. Through an increase in the degradation
of TNFα-mRNA, thalidomide reduces the production of TNFα by monocytes and
macrophages stimulated by lipopolysaccharide or by T lymphocytes induced by mitogenic
stimuli. The decreased level of TNFα alters the mechanisms of intracellular transduction by
preventing the activation of NF-kB and by decreasing the synthesis of proteins, in particular
IL-6, involved in cell proliferation, inflammation, angiogenesis and protection from apoptosis.
Furthermore, thalidomide affects VEGF levels by down-regulating its expression. Nowadays,
new safer and less toxic drugs, analogs of thalidomide, are emerging as beneficial for a more
targeted treatment of multiple myeloma and several other diseases such as Crohn's disease,
rheumatoid arthritis, sarcoidosis, erythema nodosum leprosum, graft-versus-host disease.