Immunosuppressants: tools to investigate the physiological role of cytokines.

The cyclic peptide Cyclosporine A (CsA) is best known as the immunosuppressive drug which has revolutionized organ transplantation. It selectively suppresses T cell activation by blocking the transcription of cytokine genes such as IL-2 at the level of transcription factor modulation. The structurally unrelated immunosuppressant FK 506 acts on the same pathway and blocks cytokine gene expression. In contrast, rapamycin, a structural analogue of FK 506, interferes with the immune response at a different level, by blocking the response induced by cytokines such as IL-2. Although these drugs have been most studied for their immunosuppressive activities, it is clear that their effects on cytokine pathways extend far beyond the sole IL-2-mediated responses involved in the immune response. For instance, CsA and FK 506 inhibit the transcription of IL-3, IL-4, IFN gamma, TNF alpha or GM-CSF by activated T cells, and rapamycin has been shown to block the response to various growth factors such as IL-3, IL-4 or IL-6. Here, we recap what is known about the effects of CsA, FK 506 and rapamycin on hematopoiesis in vitro and in vivo and extrapolate on what these drugs can teach us about the physiological role of cytokines for hematopoiesis.