Recent advances in defining the role of misoprostol in rheumatology.

Recent findings suggest that the prostaglandin E1 analog misoprostol may be associated with significant antiinflammatory and immunomodulatory effects. The addition of misoprostol to diclofenac significantly reduced the effective dose of the latter in the carrageenan acute inflammation rat model. A number of in vitro and animal studies have shown that misoprostol substantially increases the immunomodulatory effect of cyclosporine or steroids, and a study in renal transplant recipients revealed that the addition of this agent to cyclosporine and steroid treatment produced a significant improvement in renal function and a marked decrease in the incidence of graft rejection. Further, other recent data suggest that misoprostol may exert a protective effect against the damage to cartilage that appears to be induced by some nonsteroidal antiinflammatory drugs by decreasing the synthesis of cytokines. Further studies of misoprostol in these various contexts are warranted.