Tumor necrosis factor as a therapeutic target of rheumatologic disease.
TNF-alpha is a crucial pro-inflammatory and immunoregulatory cytokine that is central to the pathogenesis of various inflammatory and autoimmune conditions. A number of controlled trials have shown effectiveness for TNF-alpha inhibitors in several diseases, in particular rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and Crohn's disease. These agents may also be useful in additional autoimmune conditions. The introduction of TNF-alpha inhibitors has revolutionized the therapeutic approach and treatment paradigms especially for patients with rheumatoid arthritis. Despite extensive investigation, the full profile of their mechanisms of action remain incompletely understood. Optimal use of these agents requires consideration of their possible adverse effects. In addition to the presently available TNF-alpha blockers, other agents targeting this key mediator are under study. Recent advances and future directions in anti-TNF-alpha therapy are discussed in this paper.
Ackermann
Christoph
C
University of California, Center for Innovative Therapy, Divison of Rheumatology, Allergy and Immunology, San Diego, La Jolla, CA 92093-0943, USA.
Kavanaugh
Arthur
A
D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D001327:Autoimmune Diseases / Q000188:drug therapy / Q000503:physiopathology; D018849:Controlled Clinical Trials as Topic; D016503:Drug Delivery Systems; D017850:Economics, Pharmaceutical; D006801:Humans; D018124:Receptors, Tumor Necrosis Factor / Q000276:immunology / Q000378:metabolism; D012216:Rheumatic Diseases / Q000188:drug therapy* / Q000503:physiopathology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000378:metabolism
D018501:Antirheumatic Agents; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha