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Tumor necrosis factor inactivation in the management of rheumatoid arthritis
1Physicians Clinic of Spokane and the Department of Medicine, University of Washington School of Medicine, 99204, USA.
Abstract:
Biologic agents that target molecules and cells involved in chronic inflammation are coming into clinical use for the treatment of rheumatoid arthritis (RA). New agents block the action of cytokines, which play a key role in the pathogenesis of RA. Among the many cytokines involved in RA, tumor necrosis factor (TNF) is believed to be dominant. Two agents for neutralizing TNF are now available. One is a recombinant molecule, etanercept, which is derived from a naturally occurring TNF antagonist, one of the soluble human TNF receptors. The other, infliximab, is a chimeric (human-mouse) monoclonal antibody against human TNF. These biologic agents have been shown to relieve symptoms in patients with refractory RA. If tolerance of these and other anticipated anticytokine agents continues over the long term, treatment for patients with RA will become safer and more effective.
Insights
New biologic agents targeting tumor necrosis factor (TNF) offer improved treatment for rheumatoid arthritis (RA). Etanercept and infliximab provide symptom relief for patients with refractory RA, enhancing safety and effectiveness.
Area of Science:
- Immunology
- Rheumatology
- Pharmacology
Background:
- Chronic inflammation characterizes rheumatoid arthritis (RA) pathogenesis.
- Cytokines, particularly tumor necrosis factor (TNF), play a dominant role in RA.
- Biologic agents targeting inflammatory molecules are emerging for RA treatment.
Purpose of the Study:
- To review the clinical use of biologic agents targeting TNF for rheumatoid arthritis.
- To discuss the mechanisms and efficacy of etanercept and infliximab in RA treatment.
Main Methods:
- Review of current clinical data on biologic agents for RA.
- Analysis of the role of TNF in RA pathogenesis.
- Description of etanercept (recombinant TNF receptor fusion protein) and infliximab (chimeric monoclonal antibody).
Main Results:
- Etanercept and infliximab neutralize TNF, a key cytokine in RA.
- These agents have demonstrated symptom relief in patients with refractory RA.
- Biologic therapies show potential for safer and more effective RA management.
Conclusions:
- Biologic agents targeting TNF represent a significant advancement in RA treatment.
- Long-term tolerance and efficacy of these anticytokine therapies are crucial for patient outcomes.
- The development of novel biologic agents promises to improve the management of rheumatoid arthritis.