AbstractRecombinant immunosuppressants have come of age and represent a significant class of quite diverse drugs. They target extracellular molecules, and either label or inhibit them. Those targets are soluble factors or membrane proteins almost all of which are components of a very complex molecular network of communication and amplification. Notably, many recombinant immunosuppressants have been developed in a rather short period of time. This is due to the fact that developing the actual drug is left to nature, so to speak; either it is a human protein as is the case for Anakinra or it is an antibody or antibody derivative “developed” by the immune system of mice or rats following exposure to the antigen. The challenge for developing recombinant immunosuppressants is to identify relevant targets. It is no longer very difficult to generate proteins to targets, once those are identified. The clinical use of recombinant immunosuppressants has yet to show which targets are truly relevant and which drugs prove effective.