RT Journal Article
SR Electronic
T1 Should We Consider Tumor Necrosis Factor as the Only Target in Spondyloarthritides?
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 94
OP 96
DO 10.3899/jrheum.120255
VO 89
A1 GIANFRANCO FERRACCIOLI
A1 ELISA GREMESE
YR 2012
UL http://www.jrheum.org/content/89/94.abstract
AB Understanding the biology of inflammation occurring at the entheseal-bone insertion has led to a better knowledge of the main drivers of inflammation in spondyloarthropathies. The clinical efficacy of tumor necrosis factor-α (TNF-α) blockers strongly supports the idea that TNF-α is a key molecule. Yet 40% of patients do not respond appropriately, indicating that other pathways are likely involved in these illnesses. Targeting T cells through a blockade of costimulating (CD28) molecules does not help, and in experimental models of sacroiliitis, targeting interleukin 6 (IL-6) did not provide any useful evidence. Immunohistological and functional data suggest that B cells, Th17, or IL-17A might be important, and indeed preliminary data concerning drugs targeting B cells and IL-17A seem to suggest clinical benefits.