Pulmonary adverse events of anti-tumor necrosis factor-alpha antibody therapy.
It is well established that anti-tumor necrosis factor-alpha (TNFalpha) antibody is an efficacious disease-modifying drug for rheumatoid arthritis and Crohn's disease. Unfortunately, its long-term use can be associated with ominous pulmonary adverse events, most notably mycobacterial and fungal lung infections. To this end, reactivation of latent tuberculosis infection represents a serious concern of anti-TNFalpha antibody therapy. Given the anticipated increase in the approved indications for these drugs, community-based physicians should be made aware of these events for implementation of better patient selection for anti-TNFalpha antibody therapy and initiation of appropriate measures once these adverse events are observed. This review will address this issue by outlining: 1) the role of TNFalpha in host inflammatory response to injury, particularly during mycobacterial and fungal infections; 2) the salutary effects of anti-TNFalpha antibody therapy in human diseases; and 3) the ominous pulmonary adverse events associated with these drugs.
Mutlu
Gökhan M
GM
Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill 60611, USA. g-mutlu@northwestern.edu
Mutlu
Ece A
EA
Bellmeyer
Amy
A
Rubinstein
Israel
I
D000906:Antibodies / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use*; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced*; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
D000906:Antibodies; D014409:Tumor Necrosis Factor-alpha