Laboratory of Dermatology & Immunodeficiencies, Dermatology Division, Clinics Hospital, São Paulo, Brazil.
Immunotherapy. 2010 Nov;2(6):817-33. doi: 10.2217/imt.10.67.
TNF-α is a potent inducer of the inflammatory response, a key regulator of innate immunity and plays an important role in the regulation of Th1 immune responses against intracellular bacteria and certain viral infections. However, dysregulated TNF can also contribute to numerous pathological situations. These include immune-mediated inflammatory diseases (IMIDs) including rheumatoid arthritis, Crohn's disease, psoriatic arthritis, ankylosing spondylitis, ulcerative colitis and severe chronic plaque psoriasis. Animal and human studies concerning the role of TNF-α in IMIDs have led to the development of a therapy based on TNF blockage. This article focuses first on the potential mechanisms by which the three currently licensed agents, adalimumab, etarnecept and infliximab, decrease the inflammatory activity of patients with different IMIDs. Second, it focuses on the risks, precautions and complications of the use of TNF-α inhibitors in these patients.
肿瘤坏死因子-α（TNF-α）是炎症反应的强效诱导剂，是先天免疫的关键调节剂，在调节针对细胞内细菌和某些病毒感染的 Th1 免疫反应方面发挥着重要作用。然而，失调的 TNF 也可能导致许多病理情况。这些情况包括免疫介导的炎症性疾病（IMIDs），包括类风湿关节炎、克罗恩病、银屑病关节炎、强直性脊柱炎、溃疡性结肠炎和严重慢性斑块型银屑病。关于 TNF-α 在 IMIDs 中的作用的动物和人类研究导致了基于 TNF 阻断的治疗方法的发展。本文首先关注目前三种获得许可的药物（阿达木单抗、依那西普和英夫利昔单抗）降低不同 IMIDs 患者炎症活动的潜在机制。其次，本文关注在这些患者中使用 TNF-α 抑制剂的风险、注意事项和并发症。
