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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Complex cytokine effects in a complex autoimmune disease: tumor necrosis factor in systemic lupus erythematosus. | Arthritis Research Therapy Vol 5 No 4 Aringer and Smolen Commentary SLE Complex cytokine effects in a complex autoimmune disease tumor necrosis factor in systemic lupus erythematosus Martin Aringer and Josef S Smolen Department of Rheumatology Internal Medicine III University of Vienna Austria Corresponding author Josef S Smolen e-mail josef.smolen@khl.magwien.gv.at Received 7 Mar 2003 Accepted 16 Apr 2003 Published 14 May 2003 Arthritis Res Ther 2003 5 172-177 DOI 10.1186 ar770 2003 BioMed Central Ltd Print ISSN 1478-6354 Online ISSN 1478-6362 Abstract Tumor necrosis factor TNF is a proinflammatory cytokine and a B-cell growth factor. It has numerous possible effects on T lymphocytes and dendritic cells and it influences apoptosis. These differential effects may in part explain why patients under TNF-blocker therapy can develop autoantibodies to nuclear antigens and may shed some light on the finding that low TNF fosters autoimmune disease in some mouse strains. On the contrary TNF is increased in the blood and in the inflamed kidneys of systemic lupus erythematosus patients. Several studies in lupus-prone mice other than the F1 generation of New Zealand Black mice crossed with New Zealand White mice suggest that TNF is highly proinflammatory in the efferent limb and is potentially detrimental in lupus organ disease. Therefore TNF blockade probably constitutes an efficacious therapeutic option. Keywords autoantibodies cytokines immune regulation inflammation SLE Introduction Serum tumor necrosis factor TNF levels in human systemic lupus erythematosus SLE are increased 1-4 . In spite of likewise increased soluble TNF receptors TNF-R1 and TNF-R2 this increased TNF is bioactive 5 . While these findings could open the door for TNF-blocking therapy TNF exerts several different effects and TNF blockade may have a variety of consequences. There are two main reasons for some concern about using TNF blocking therapies in SLE patients. First patients with either rheumatoid
