Extract
The cytokines that modulate immune-mediated rheumatic diseases are rapidly
being
elucidated1,2.
In rheumatoid arthritis, persistent inhibition of tumor necrosis factor-alpha
(TNF-a) induces an appreciable reduction of disease activity.
TNF-a antagonists abrogate the inflammatory reaction by several
mechanisms3-5:
they reduce the expression of cytokines (TNF-a, interleukin-1a,
and interleukin-1ß), adhesion molecules, and chemokines (interleukin-8
and monocyte chemotactic protein-1) in the inflamed synovial tissue; they
diminish leukocyte chemotaxis through the endothelium; and they suppress the
activation and differentiation of osteoclasts that enhance bone
resorption.