Beyond the conventional use of immunosuppressants in organ transplantation, it has multiple applications, including controlling autoimmune diseases such as rheumatoid arthritis and multiple sclerosis. The recent pandemic of Covid -19 also sought its effectiveness in managing the later stage cytokine storm, which can otherwise lead to mortality. Regardless of recent advancements in the field, the considerably high cost of these agents is a limiting factor in organ transplantation that adds to the financial strain on patients with socioeconomic disparities. An in-depth analysis of the bioprocess engineering aspect of immunosuppressant drugs is essential to reveal the crucial points that can enhance the production of these secondary metabolites and show a way ahead for more economical production. This review aims to summarize past and current advances in bioprocessing strategies used in the field, emphasizing the production of cyclosporins, tacrolimus, mycophenolic acid, and sirolimus. An insight of producer microorganism, production parameters and their modulations as cutting-edge technology for enhanced production of these high-value and low-volume products has been provided in this study.

除了在器官移植中常规使用免疫抑制剂外，它还有多种应用，包括控制类风湿性关节炎和多发性硬化等自身免疫性疾病。最近的 Covid -19 大流行也寻求其在管理后期细胞因子风暴方面的有效性，否则可能导致死亡。尽管该领域最近取得了进展，但这些药物相当高的成本是器官移植的一个限制因素，它增加了社会经济差异患者的经济压力。对免疫抑制剂药物的生物工艺工程方面进行深入分析对于揭示可以提高这些次生代谢物产量的关键点并为更经济的生产指明道路至关重要。本综述旨在总结该领域使用的生物加工策略的过去和当前进展，重点介绍环孢菌素、他克莫司、霉酚酸和西罗莫司的生产。本研究提供了对生产微生物、生产参数及其调节作为提高这些高价值和小批量产品生产的尖端技术的见解。