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Arthritis Research & Therapy
Erschienen in: Arthritis Research & Therapy 1/2000

01.11.2000 | Review

Anti-cytokine therapy in chronic destructive arthritis

verfasst von: Wim B van den Berg

Erschienen in: Arthritis Research & Therapy | Ausgabe 1/2000

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Abstract

Tumor necrosis factor (TNF) and interleukin-1 (IL-1) are considered to be master cytokines in chronic, destructive arthritis. Therapeutic approaches in rheumatoid arthritis (RA) patients have so far focused mainly on TNF, which is a major inflammatory mediator in RA and a potent inducer of IL-1; anti-TNF therapy shows great efficacy in RA patients. However, it is not effective in all patients, nor does it fully control the arthritic process in affected joints of good responders. Directed therapy for IL-1, with IL-1 receptor antagonist, mainly reduces erosions and is marginally anti-inflammatory. It is as yet unclear whether the limited effect is akin to the RA process or linked to suboptimal blocking of IL-1. Analysis of cytokine patterns in early synovial biopsies of RA patients reveals a marked heterogeneity, with variable staining of TNF and IL-1β, indicative of TNF-independent IL-1 production in at least some patients. Evidence for this pathway emerged from experimental arthritises in rodents, and is summarized in this review. If elements of the models apply to the arthritic process in RA patients, it is necessary to block IL-1β in addition to TNF.
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Metadaten
Titel
Anti-cytokine therapy in chronic destructive arthritis
verfasst von
Wim B van den Berg
Publikationsdatum
01.11.2000
Verlag
BioMed Central
Erschienen in
Arthritis Research & Therapy / Ausgabe 1/2000
Elektronische ISSN: 1478-6362
DOI
https://doi.org/10.1186/ar136

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