Immunomodulative effects of artemisinin and its derivatives in the relative diseases

Artemisinin and its derivatives are widely used as first-line antimalarials in the world. Currently, artemisinin derivatives used in clinical treatment include dihydroartemisinin, artemether, artesunate and arteether, etc. Scientists from Shanghai Institute of Materia Medica(SIMM, CAS) designed a series of novel artemisinin derivatives such as SM735, SM905 and SM934, with lower toxicity, higher bioavailability, and potent immunosuppressive activity. In recent years, more and more clinical and trial evidences show that artemisinin and its derivatives have strong anti-inflammatory, anti-tumor and immunomodulative effects in addition to their prominent anti-malaria effect. Artemisinin and its derivatives play an immunosuppressive role by inhibiting the activation of pathogenic T cells, inhibiting the activation of B cells and the production of antibodies, and increasing the expression of regulatory T cells, thereby improving the symptoms of autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. Artemisinin and its derivatives can also regulate tumor immunity by regulating mammalian immune T cells, induce apoptosis and inhibit tumor cell growth, and play anticancer roles in the treatment of various cancers such as breast cancer and lung cancer. Meanwhile, researchers around the world are still exploring the unknown biological activity of artemisinin derivatives. In order to provide reference for the wider application and development of novel artemisinin drugs, we are discussing the latest progress in this review on the immunomodulatory mechanism of artemisinin and its derivatives and its role in autoimmune diseases, inhibiting the proliferation, promoting apoptosis of tumor cells, inducing cell cycle arrest, interfering with tumor invasion and metastasis, regulating tumor signaling pathways, etc.