The role of tumor necrosis factor-alpha in systemic lupus erythematosus.
Murine models of systemic lupus erythematosus (SLE) have shown apparently contradictory evidence in that either (a) tumor necrosis factor (TNF) expression was low and TNF administration helpful or (b) TNF was high and TNF blockade of therapeutic benefit, depending on the mouse model investigated. In fact, TNF apparently has both effects, checking autoimmunity, at least to some degree, and fostering inflammation. TNF blockade regularly, but transiently, induces or increases autoantibodies to chromatin and to phospholipids. At the same time, open-label data suggest that TNF blockade suppresses inflammatory manifestations of SLE, and long-term benefit was seen in patients with lupus nephritis. A controlled clinical trial is under way.
Aringer
Martin
M
Division of Rheumatology, Department of Medicine III, University Clinical Center Carl Gustav Carus, Technical University of Dresden, Fetscherstrasse 74, 01307 Dresden, Germany. martin.aringer@uniklinikum-dresden.de
Smolen
Josef S
JS
D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001323:Autoantibodies / Q000096:biosynthesis; D015551:Autoimmunity / Q000187:drug effects; D002843:Chromatin / Q000276:immunology; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000517:prevention & control; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000276:immunology / Q000378:metabolism*; D008181:Lupus Nephritis / Q000188:drug therapy; D010743:Phospholipids / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000276:immunology / Q000378:metabolism* / Q000494:pharmacology
D000911:Antibodies, Monoclonal; D001323:Autoantibodies; D002843:Chromatin; D010743:Phospholipids; D014409:Tumor Necrosis Factor-alpha