Tumor necrosis
factor:
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The TNF family,
of which Tumor Necrosis Factor Alpha (TNF-A), is the prototype, contains more
than 17 cytokines with important functions in adaptive and innate immunity.
Tumor
Necrosis Factor Alpha (TNF-A):
· TNF-A acts on endothelial cells and stimulates the expression of adhesion molecules and aids the extravasation of inflammatory cells.
· It stimulates endothelial cells to express proteins that trigger blood clotting in the local small vessels, occluding them and cutting off blood flow.
· This is important in preventing the pathogen from entering the bloodstream and spreading.
· However, TNF-A can become catastrophic if the infection spreads. Sepsis causes a massive release of TNF-A from macrophages throughout the body. The systemic release of TNF-A into the bloodstream causes vasodilation, which leads to a loss of blood pressure and increased vascular permeability, leading to a loss of plasma volume and eventually to shock, known as septic shock.
Therapeutic
uses of inhibition of TNF-A:
·
Anti-TNF-A
antibodies have been found to induce remissions in rheumatoid arthritis and
decrease inflammation in Crohn's disease.
·
There
are two types of established drugs that are used to antagonize TNF-A in
clinical practice:
·
The
first type comprises the anti-TNF-A antibodies, such as infliximab and
adalimumab, which bind to TNF-A and block its activity.
·
The
second type I a recombinant human TNF receptor (TNFR) subunit p75-Fc fusion
protein called etanercept, which binds TNF-A, thereby neutralizing its
activity.
Tumor Necrosis Factor Beta (TNF-B):
·
It
is secreted by Th1 cells and cytotoxic T cells, is also known as
Lymphotoxin-alpha.
·
It activates
macrophages and has a direct cytotoxic effect on some cells.
·
It
also inhibits B cells.
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