Cytokines in rheumatoid arthritis: is it all TNF-alpha?
Anti-TNF-alpha therapy has shown clear efficacy in the treatment of rheumatoid arthritis (RA). Since some patients do not respond and the treatment is suspensive, combination therapy may be of interest. Other cytokines produced by monocytes such as IL-1, IL-12, IL-18 are also involved. The secretion of these cytokines is regulated by subsets of T-lymphocytes. Among these, IL-17 producing Th1 cells appear to contribute directly to the destructive process. Furthermore, this T-cell contribution enhances the action of monocyte derived proinflammatory cytokines. Using models of human RA synovium inflammation and bone resorption, ex vivo results suggest that combination therapy may be of interest. Acting on more than one cytokine may increase the percentage of responding RA patients as well as the degree of individual patient response.
Miossec
P
P
Department of Immunology and Rheumatology, Hôpital Edouard Herriot, Lyon, France. miossec@laennec.univ-lyon.fr
D000818:Animals; D019138:Antibodies, Blocking / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D016207:Cytokines / Q000037:antagonists & inhibitors* / Q000276:immunology*; D006801:Humans; D051379:Mice; D009000:Monocytes / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology*
D019138:Antibodies, Blocking; D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha