Understanding molecular mechanisms in multivariant actions of levamisole as an anti-helminthic, anti-inflammatory, antioxidant, anti-neoplastic and immunomodulatory drug

Levamisole is an imidothiazole derivative with a wide variety of applications in medical field. It has long been used as an anti-helminthic where its primary action is through the opening of acetyl choline receptor channels. It is widely used as an immunomodulatory drug through its action on dentritic cells and by enhancing the release of cytokines like interleukins 12 and 10. The antioxidant action of levamisole is by the enhancing effect on the major cellular redox systems like glutathione, enzymes like superoxide dismutase, catalase and also possible effects on glutathione related enzymes. On the other hand, the anti-inflammatory action is by the inhibition of TNF-alpha (tumor necrosis factor) and interleukin 6. Anti-neoplastic action of levamisole is by two ways that is, through its apoptotic action causing cell cycle inhibition and increased endothelial cell adhesion and the second action is through its anti-angiogenic property. This article enlightens upon the various mechanisms of action of levamisole at molecular level describing its diverse uses as an anti-helminthic, immunomodulatory, anti-neoplastic, anti-inflammatory and antioxidant drug.