Anti-TNF drugs bring relief from rheumatoid arthritis
BY DR. KOMOROFF Universal Uclick
Wednesday, October 31, 2012
Dear Doctor K: I have rheumatoid
arthritis and take anti-TNF drugs. I’d
like to understand how they work.
Dear Reader: Rheumatoid
arthritis (RA) is a chronic autoimmune
disease in which the
body’s immune system mistakenly
attacks healthy tissue in
the joints. When the immune
system attacks anything — a
foreign germ or the body’s own
tissue — it acts like an army.
There are immune system cells
that are like the generals: They
direct the troops. They do so by
sending chemical signals that
tell other cells to attack or to
stop attacking.
One of these chemical signals
is a molecule called tumor necrosis
factor, or TNF. It’s one of
the “attack” signals. TNF binds
to normal joint tissues and
increases inflammation. Anti-
TNF drugs bind to the receptor
sites on the joint tissue cells,
blocking the TNF from causing
destructive inflammation.
(There’s an illustration of how
anti-TNF drugs work on my
website, tulsaworld.com/DrK.)
In rheumatoid arthritis, the
inflammation begins in the
synovium, a thin membrane
that lines the joints. There,
something (we don’t yet know
what) triggers an inflammatory
reaction. As a result, joint cells
produce harmful substances
that attack the joints. Synovial
cells also proliferate, forming a
rough, grainy tissue that grows
into the joint cavity and eats
away at cartilage.
The goals in treating RA are
to prevent or control joint damage,
prevent loss of function
and reduce pain. To prevent
permanent damage, the disease
is often treated aggressively
from the start.
Anti-TNF agents are among
a newer generation of drugs.
They can improve the symptoms
of rheumatoid arthritis
and slow the progressive damage
to the joints.
Anti-TNF drugs are potent
and expensive, and they can
have serious side effects. But
they appear to do what other
drugs have failed to do: stop the
rate of joint deterioration. In
fact, in a number of people with
RA, these drugs have induced
something close to remission.
Write Dr. K at www.AskDoctorK.comor c/o Universal Uclick, 1130 Walnut,
Kansas City, MO 64106
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