A follow-up to "Anti-cytokine therapy in chronic destructive arthritis" by Wim B van den Berg |
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Authors: | Fionula M Brennan |
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Institution: | (1) Kennedy Institute of Rheumatology Division, Imperial College School of Medicine, Hammersmith, London, UK |
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Abstract: | In recent years, the effectiveness of anti-TNF therapy in treating rheumatoid arthritis (RA) has become apparent. While trials of IL-1 receptor antagonist in RA have been encouraging, it clearly is more difficult to target two molecules (IL-1 α and β) than one (TNF-α). In his review article, Professor Wim van den Berg argues that both TNF-α and IL-1 must be blocked in RA and that although TNF is clearly a potent inflammatory molecule, the dominant cytokine in the subsequent degradation of the joint tissue is IL-1. This commentary discusses his hypothesis in light of animal studies and the limitations of the conclusions that can be drawn from them. More broadly, it discusses the biology of TNF-α and IL-1 and suggests explanations of why TNF-α is a pivotal cytokine in this disease. |
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