Pioglitazone as a potential modulator in autoimmune diseases: a review on its effects in systemic lupus erythematosus, psoriasis, inflammatory bowel disease, and multiple sclerosis.

Nasrabadi, Mohammad Esmail; Al-Harrasi, Ahmed; Mohammadi, Saeed; Zarif Azam Kardani, Fateme; Rahmati, Mina; Memarian, Ali

Introduction: Current medications for autoimmune disorders often induce broad-ranging side effects, prompting a growing interest in therapies with more specific immune system modulation. Pioglitazone, known for its anti-diabetic properties, is increasingly recognized for significant immunomodulatory potential. Beyond its traditional use in diabetes management, pioglitazone emerges as a promising therapeutic candidate for autoimmune disorders. Areas covered: This comprehensive review explores pioglitazone's impact on four prominent autoimmune conditions: systemic lupus erythematosus, psoriasis, inflammatory bowel disease, and multiple sclerosis. We focus on pioglitazone's diverse effects on immune cells and cytokines in these diseases, highlighting its potential as a valuable therapeutic option for autoimmune diseases. Here we have reviewed the latest and most current research literature available on PubMed, based on research published in the last 15 years. Expert opinion: Pioglitazone as an immunomodulatory agent can regulate T cell differentiation, inhibit inflammatory cytokines, and promote anti-inflammatory macrophages. While further clinical studies are needed to fully understand its mechanisms and optimize treatment strategies, pioglitazone represents a potential therapeutic approach to improve outcomes for patients with these challenging autoimmune conditions. The future of autoimmune disease research may involve personalized treatment approaches, and collaborative efforts to improve patient quality of life. Plain Language Summary: This article explores the potential use of pioglitazone, a medication commonly used to treat diabetes, for autoimmune disorders treatment. The focus of the review centers around the effects of pioglitazone on systemic lupus erythematosus, psoriasis, inflammatory bowel disease, and multiple sclerosis. In the case of systemic lupus erythematosus, pioglitazone appears to induce a shift in specific immune cells, leading to a reduction in systemic inflammation and damage to organs. In psoriasis, the medication shows promise in suppressing immune responses, thereby alleviating skin inflammation. For individuals with inflammatory bowel disease, pioglitazone seems to safeguard a protein with anti-inflammatory properties, aiding in the repair of bowel tissue. Regarding multiple sclerosis, pioglitazone appears to influence the behavior of immune cells and promote the restoration of nerve tissue. These diverse effects of pioglitazone on the immune system suggest its potential as a valuable treatment option for autoimmune diseases. However, it is important to note that further research is necessary to fully comprehend the mechanisms by which pioglitazone operates and to determine the optimal approaches for its utilization in clinical studies.

INFLAMMATORY bowel diseases; SYSTEMIC lupus erythematosus; T cell differentiation; AUTOIMMUNE diseases; NERVE tissue

Expert Review of Clinical Immunology, 2025, Vol 21, Issue 1, p5

1744-666X

Academic Journal

10.1080/1744666X.2024.2401614