Tumor necrosis factor-alpha monoclonal antibodies for Crohn's disease: tipping the balance.
Crohn's disease (CD) is a chronic inflammatory disorder which may involve any part of gastrointestinal tract. Chronic inflammation is primarily due to an immunological imbalance between pro- and anti-inflammatory cytokines, and with a defective apoptosis of lamina propria T cells. Amongst the pro-inflammatory cytokines tumor necrosis factor-alpha (TNF-alpha) seems to play a central role in pathogenesis of CD. Over the last years, increasing knowledge on the pathogenesis of CD together with progresses in bio-technology have led to the development of a number of biological agents targeting specific molecules involved in gut inflammation, most importantly TNF-alpha and its receptors. The aim of this paper is to critically review the rationale and state-of-the art for the use TNF- alpha inhibitors in the treatment of CD.
Danese
Silvio
S
Division of Gastroenterology, Istituto Clinico Humanitas, IRCCS in Gastroenterology, Rozzano, Milan, Italy. sdanese@hotmail.com
Pagano
Nico
N
Angelucci
Erika
E
Stefanelli
Tommaso
T
Repici
Alessandro
A
Omodei
Paolo
P
Daperno
Marco
M
Malesci
Alberto
A
D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D003424:Crohn Disease / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D013329:Structure-Activity Relationship; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology
D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha