[Effects of TNF antagonists on immune and neuroendocrine system].
In the article, the literature on the effects of TNFα-antagonists (etanercept, infliximab and adalimumab) on the immune system is reviewed. These biologic agents are employed in chronic inflammatory diseases such as rheumatoid arthritis, seronegative spondyloarthritides, as well as psoriasis and Crohn's disease. The differences of these drugs, testified by the different effects on the immune response, are discussed. These molecules exert their effect through cytokine inhibition, but they present striking differences since they can modulate macrophage activity, T cells apoptosis, leukocyte migration, and angiogenesis to a different degree. Some studies showed that these agents also affect the hypothalamo-pituitary-adrenal axis. The potential immunogenicity of these biologic agents is also discussed.
Valesini
G
G
Dipartimento di Clinica e Terapia Medica Applicata, Cattedra di Reumatologia, Università degli Studi La Sapienza, Roma, Italia. guido.valesini@uniroma1.it
Cutolo
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M
D000068879:Adalimumab; D000888:Antibodies, Anti-Idiotypic / Q000096:biosynthesis; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000276:immunology / Q000494:pharmacology* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003424:Crohn Disease / Q000188:drug therapy; D000068800:Etanercept; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects; D007107:Immune System / Q000187:drug effects*; D007074:Immunoglobulin G / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D000069285:Infliximab; D016131:Lymphocyte Subsets / Q000187:drug effects; D008262:Macrophage Activation / Q000187:drug effects; D009490:Neurosecretory Systems / Q000187:drug effects*; D010913:Pituitary-Adrenal System / Q000187:drug effects; D011565:Psoriasis / Q000188:drug therapy; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000037:antagonists & inhibitors; D012216:Rheumatic Diseases / Q000188:drug therapy; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept