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Related Experiment Videos

Autoimmunity and anti-TNF-alpha agents.

Fabiola Atzeni1, Maurizio Turiel, Franco Capsoni

  • 1Rheumatology Unit, Department of Rheumatology, University Hospital L Sacco, Via GB Grassi 74, 20157 Milan, Italy. sarzi@tiscali.it

Annals of the New York Academy of Sciences
|August 30, 2005
PubMed
Summary

Anti-tumor necrosis factor-alpha (anti-TNF-alpha) biologics reduce specific autoantibodies like rheumatoid factor (RF) and anticyclic citrullinated peptide (anti-CCP) in rheumatoid arthritis (RA) patients. However, these treatments can also induce other autoantibodies, such as antinuclear antibodies (ANAs).

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Area of Science:

  • Immunology
  • Rheumatology
  • Pharmacology

Background:

  • Biologic agents targeting anti-tumor necrosis factor-alpha (anti-TNF-alpha) are used to treat rheumatoid arthritis (RA).
  • These therapies have been linked to changes in autoantibody levels, including reductions in specific autoantibodies and induction of others.
  • The precise mechanisms underlying these autoantibody alterations remain under investigation.

Purpose of the Study:

  • To investigate the effects of anti-TNF-alpha biologic agents on autoantibody profiles in patients with RA and Crohn's disease (CD).
  • To summarize the induction rates of various autoantibodies, including antinuclear antibodies (ANAs), anti-dsDNA, and antiphospholipid antibodies (aPLs), following treatment with different anti-TNF-alpha agents.

Main Methods:

  • Review of clinical trial data and published literature on patients treated with anti-TNF-alpha biologics.

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  • Analysis of autoantibody levels (RF, anti-CCP, ANAs, anti-dsDNA, aPLs) before and after treatment.
  • Quantification of autoantibody induction rates associated with specific anti-TNF-alpha agents like infliximab, etanercept, and adalimumab.

    • Main Results:

    • Anti-TNF-alpha therapy is associated with decreased levels of rheumatoid factor (RF) and anticyclic citrullinated peptide (anti-CCP).
    • Treatment with infliximab induced ANAs in 63.8% of RA patients and 49.1% of CD patients, and anti-dsDNA in 13% of RA patients.
    • Etanercept and adalimumab also showed induction of ANAs and anti-dsDNA antibodies in varying percentages of patients, with limited data on aPL induction.

    Conclusions:

    • Anti-TNF-alpha biologics modulate autoantibody production in RA and CD patients.
    • While specific autoantibodies decrease, non-organ-specific autoantibodies like ANAs and anti-dsDNA can be induced, potentially due to the anti-inflammatory effects of these agents.
    • Further research is needed to fully elucidate the mechanisms and clinical implications of these autoantibody changes.