NF-κB-IKKβ Pathway as a Target for Drug Development: Realities, Challenges and Perspectives

Background: Nuclear factor kappa B (NF-kappa B) comprises a family of proteins that act as transcription factors promoting the expression of many genes. Activation of NF-kappa B biochemical cascades is associated with the regulation of innate and adaptive immune responses and inflammation, among other physiological responses. However, genetic abnormalities and continuous stimulation of the NF-kappa B-IKK beta pathway are directly related to many types of inflammatory and autoimmune diseases, as well as to the genesis and survival of tumor cells. Objectives: Inhibition of the NF-kappa B-IKK beta cascade can be considered an attractive therapeutic method for the genesis of new prototypes to combat these chronic multifactorial diseases. Results: This review describes some prototypes and drugs that act to inhibit the NF-kappa B-IKK beta pathway, highlighting the realities, challenges and perspectives for therapeutic use. Conclusion: Although only proteasome inhibitors, such as bortezomib and carfilzomib, are a reality as therapeutically useful drugs among the known modulators of possible targets in the NF-kappa B-IKK beta pathway, some other prototypes described as IKK beta inhibitors have entered clinical stages as drug candidates for the control of inflammatory diseases. It is important to note that some classical drugs available on the pharmaceutical market, such as acetylsalicylic acid, were also described more recently as NF-kappa B pathway modulators as IKK beta inhibitors.