4.8 Review

Emerging principles of cytokine pharmacology and therapeutics

Journal

NATURE REVIEWS DRUG DISCOVERY
Volume 22, Issue 1, Pages 21-37

Publisher

NATURE PORTFOLIO
DOI: 10.1038/s41573-022-00557-6

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The use of cytokines for therapeutic purposes has been restricted due to their pleiotropic activity. However, recent insights from structural biology, protein engineering, and receptor pharmacology have provided strategies to overcome cytokine pleiotropy and develop improved cytokine-based therapeutics.
The exploitation of cytokines for therapeutic use has been limited by their pleiotropic activity, which has contributed to dose-limiting toxicity and lack of efficacy. Here, Garcia and colleagues discuss how recent insights from structural biology, protein engineering and receptor pharmacology have unveiled strategies to overcome cytokine pleiotropy and enable the design of new and improved cytokine-based therapeutics. Cytokines are secreted signalling proteins that play essential roles in the initiation, maintenance and resolution of immune responses. Although the unique ability of cytokines to control immune function has garnered clinical interest in the context of cancer, autoimmunity and infectious disease, the use of cytokine-based therapeutics has been limited. This is due, in part, to the ability of cytokines to act on many cell types and impact diverse biological functions, resulting in dose-limiting toxicity or lack of efficacy. Recent studies combining structural biology, protein engineering and receptor pharmacology have unlocked new insights into the mechanisms of cytokine receptor activation, demonstrating that many aspects of cytokine function are highly tunable. Here, we discuss the pharmacological principles underlying these efforts to overcome cytokine pleiotropy and enhance the therapeutic potential of this important class of signalling molecules.

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