Immune 4



The development of TNF-α inhibitors in 1990s ushered in a new era of therapy of autoimmune disease using “biologicals” capable of interfering with the interactions between cytokines and their receptors. The initial clinical use of TNF inhibitors such as etanercept (a soluble recombinant TNF receptor II linked to the Fc portion of human IgG1), infliximab (a chimeric human-mouse anti-TNF-α monoclonal antibody), and adalimumab (a fully humanized monoclonal antibody against TNF-α) in RA demonstrated that although multiple cytokines may be involved in disease pathogenesis (in RA, IL-1 and IL-6 in addition to TNF-α), inhibitors of a single cytokine pathway may show therapeutic efficacy. In addition to RA, TNF-α inhibitors are used for treating  inflammatory bowel disease, psoriasis, and psoriatic arthritis and are being tested in sarcoidosis, Wegener’s granulomatosis, pyoderma gangrenosum, SLE and Behcet’s syndrome

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