Targeting tumor necrosis factor alpha - New drugs used to modulate inflammatory diseases

Tumor necrosis factor alpha (TNF-alpha) is an inflammatory cytokine with a role in several biologic systems, including immune modulation and host defe nse against tumors and infections. The role of TNF-alpha in inflammatory di seases is increasingly understood. Its role in the pathophysiology of Crohn 's disease, rheumatoid arthritis, and many inflammatory skin disorders is w ell established. Three drugs that target TNF-alpha recently have come to ma rket. Thalidomide enhances the degradation of mRNA encoding TNF-alpha, but also has immune-modulating properties. This drug has a notorious history, b ut is emerging as a therapeutic agent to treat inflammatory, autoinumme, an d neoplastic diseases. Etanercept and infliximab are newer, more specific T NF-alpha antagonists that are showing promise as therapeutic agents. The au thors describe these three drugs, their mechanisms, and indications. In add ition, they speculate about the potential role of these TNF-alpha antagonis ts in treating various skin conditions.