Fig. 2.

Potential mechanisms of action of melanocortin peptides in the treatment of systemic lupus erythematosus. Melanocortin peptides may reduce disease activity through multiple potential mechanisms, including the following: systemically induced immunosuppression and anti-inflammation in disease-related target organs and tissues secondary to ACTH-induced steroidogenesis, direct effects of MCR activation on systemically induced immunosuppression and anti-inflammation, including regulation of B and T lymphocytes and macrophages, direct effects of MCR activation on hepatic cells to correct dyslipidemia and possibly reduce accelerated atherosclerosis, direct immunosuppressive and anti-inflammatory effects of MCRs expressed in the epidermis and dermis on chronic cutaneous lesions, direct protective effects of MCR activation on kidney cells particularly podocytes, and direct anti-pyretic and neuroprotective effects of MCRs expressed in the central nervous system and central neurogenic anti-inflammation to reduce inflammation-associated neurologic and psychiatric manifestations [94] (reprinted by permission from Macmillan Publishers Ltd).