title: Specific TNF-alpha inhibition in cerebral aneurysm formation and subarachnoid hemorrhage.
abstract: The signal transduction of tumor necrosis factor-alpha (TNF-alpha) is complex and regulated via a vast number of interconnecting pathways. The TNF-alpha signaling pathway plays a major role in the pathogenesis of subarachnoid hemorrhage (SAH). The advent of molecular mimicry has provided a number of opportunities to tackle disease with improved specificity. Here we review the mechanisms of their action and the potential for TNF-alpha inhibitors as a treatment for subarachnoid hemorrhage. Searches were performed using PubMed with the search terms "subarachnoid haemorrhage", "TNF alpha", "novel drugs" TNF alpha inhibition", "management", "cerebral aneurysm", and "vasospasm" from 1970 to February, 2012. Articles were also identified through searches of the Cochrane library and searches of the authors' own files. Only papers published in English were reviewed. In conclusion, there is considerable theoretical evidence for the potential of TNF-alpha inhibitors to impact on the pathogenesis of aneurismal SAH. Such indications demonstrate the potential for specific targeting of molecular signaling pathways to prevent the growth and rupture of cerebral aneurysm.
authors.affiliation: Department of Neurosurgery, Harvard Medical School, Massachusetts General Hospital, Boston, 02114, USA. ay276@cam.ac.uk
authors.forename: Adam M H
authors.initials: AM
authors.lastname: Young
authors.forename: Surya K
authors.initials: SK
authors.lastname: Karri
authors.forename: Wanchun
authors.initials: W
authors.lastname: You
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Ogilvy
mesh_terms: D000818:Animals; D002560:Cerebrovascular Circulation / Q000187:drug effects; D006801:Humans; D002532:Intracranial Aneurysm / Q000188:drug therapy*; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000502:physiology; D015398:Signal Transduction / Q000502:physiology; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000037:antagonists & inhibitors* / Q000502:physiology
chemical_list: D047888:Receptors, Tumor Necrosis Factor, Type I; D014409:Tumor Necrosis Factor-alpha