<prompt> Mechanism of action of thalidomide is: March 2013AntimicrobialAntiemeticAnti-allergicImmunomodulation  <response>: Ans. D i.e. Immunomodulation Thalidomide It is a synthetic derivative of glutamic acid alpha-phthalimido-glutarimide with teratogenic, immunomodulatory, anti-inflammatory and anti-angiogenic propeies. Thalidomide acts primarily by inhibiting both the production of tumor necrosis factor alpha TNF-alpha in stimulated peripheral monocytes and the activities of interleukins and interferons. This agent also inhibits polymorphonuclear chemotaxis and monocyte phagocytosis. In addition, thalidomide inhibits pro-angiogenic factors such as vascular endothelial growth factor VEGF and basic fibroblast growth factor bFGF, thereby inhibiting angiogenesis. 