Table 1.
Overview on currently applied and experimental pharmacological treatments in EPS.
| Class | Drug Name | Mode of Action |
|---|---|---|
| Glucocorticosteroids | Prednisone | Immunosuppressant, inhibits monocyte chemoattractant protein 1 (MCP-1) synthesis, regulates extracellular matrix (ECM) protein synthesis, ECM protein maturation |
| Prednisolone | ||
| Immuno-suppressants | Azathioprene | Inhibits DNA/RNA synthesis |
| Rapamycin/Sirolimus | Inhibits T-cell/B-cell activation | |
| Mycophenolate mofetil | De-novo purine synthesis blockade | |
| Cyclosporine | Lowered T-cell activity | |
| Hormonal antagonist | Tamoxifen | Blocks transforming growth factor-β1 (TGF-β1) signaling |
| Angiotensin converting enzyme inhibitor (ACEi)/Angiotensin II receptor blocker (ARB) | Blocks TGF-β1 signaling | |
| Perindopril | Blocks TGF-β1 signaling, lowered cell proliferation | |
| Candesartan | ||
| Mucolytic | Ν-acetylcysteine (NAC) | Reactive oxygen species scavenger |
| alkaloid | Colchicine | Blocks TGF-β1 mRNA expression |
| Xanthine derivative | Pentoxifylline | Fibrinoltyic, suppressed collagen synthesis, angiogenesis |
| Anti-diabetic | Rosiglitazone | Peroxisome Proliferator-Activated Receptor (PPAR)-agonist, suppressed inflammation, neovasculature |
| Anti-fibrotic, anti-inflammatory | Pirfenidone | Reduces tissue inhibitor of metalloproteinases-1 (TIMP-1), tumor necrosis factor-α (TNF-α), and TGF-β1 expression, |
| Immuno-modulator | Thalidomide | Anti-angiogenic, anti-proliferative, antifibrotic |
| Anti-fungal | Itraconazole | Decreased TGF-β1 expression |
| Autologous stem cell therapy | Mesothelial/submesothelial cellular layer repair |