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.

中文翻译：

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沙利度胺的综述：化学，作用机制，治疗潜力和多发性骨髓瘤的抗血管生成特性。

沙利度胺是一种具有令人感兴趣的治疗特性的药物，而且还具有严重的副作用，需要仔细和监测使用。潜在的免疫调节，抗炎，抗血管生成和镇静作用使沙利度胺成为治疗多种疾病（例如多发性骨髓瘤）的良好候选者。通过增加TNFα-mRNA的降解，沙利度胺减少了由脂多糖或有丝分裂刺激物诱导的T淋巴细胞刺激的单核细胞和巨噬细胞的TNFα产生。TNFα水平的降低通过阻止NF-κB的活化并通过减少参与细胞增殖，炎症，血管生成和细胞凋亡保护的蛋白质特别是IL-6的合成而改变了细胞内转导的机制。此外，沙利度胺通过下调其表达来影响VEGF水平。如今，新的更安全，毒性更小的药物沙利度胺的类似物正在成为对多发性骨髓瘤和其他几种疾病（例如克罗恩病，类风湿性关节炎，结节病，结节性红斑麻风病，麻风病，移植物抗-宿主疾病。