Watch a video about TNF inhibitors (Tumor necrosis factor), and find out how this new treatment may help you.
Read the full transcript »
Caryn Hasselbring: TNF is a Cytokine, as I said it’s released by activated cells on this turned on immune system and what it does is it causes the Synovial lining cells or the lining cells in the joint to release the collagenase, which then causes the joint destruction. The elevated levels do some other things, they seem to be important in causing those extreme fatigue and some of the –- the stomach just not feeling well symptoms that patients with Rheumatoid Arthritis experience. W. Haynes Wilson: We also have biologics, we call them the TNF inhibitors and there really are two basic ways to do that. On the one side, we have a TNF inhibitor called Etanercept Enbrel, which is -- it’s called TNF receptor antagonist. So it’s kind of a fake out for the immune system. What you do is you inject it under your skin and it's a receptor that’s not hooked up to the cell. So what happens is that protein that usually promotes inflammation, comes up and hooks up to the receptor. Well, if it were hooked up -- if that receptor was hooked up to the cell, the cell would turn on and it would become inflame. But because it isn’t then it’s just sort of -- it binds it up and moves it away. The other two types Humira and Remicade, those type medicines actually are monoclonal antibodies, which means they are specific proteins that are made to come in and bind up that TNF protein, the one that promotes in information they come in and grab it just like an antibody, if you were sick, you might have an antibody against streptococcal pneumonia, you might make an antibody against that and that antibody would help get rid of that streptococcal pneumonia. Well, this antibody actually, is against the TNF, which is the protein that your body makes that promotes inflammation. So when you get rid of TNF, you greatly decrease information and they have been dramatic drugs in the treatment of Rheumatoid Arthritis. Caryn Hasselbring: Yeah they actually block their ability to signal the Synovial Lining cells to actually, produce the joint damaging substances. W. Haynes Wilson: I was at the Arthritis Foundations national meeting two years ago, one of the ladies said that she had Arthritis for 25 years, and she started one of these TNF inhibitors and all of a sudden, she noticed she could wash her hair and she just started crying, because a lot of times we don’t realize how much we take it for granted. But something that just makes your hands go from here to here, where you can wash your hair is a dramatic difference for patients. So bringing down that TNF in conjunction often times with something like Methotrexate, can make all the difference in a patient’s life. Caryn Hasselbring: The brand names are Anvil, Remicade and Humira are the main drugs that you'll see apertized, the generic names the chemical name would be Etanercept and Infliximab and Adalimumab. That’s just a tremendous breakthrough. W. Haynes Wilson: Even I always say, that it’s a greatest time in the world to be a Rheumatologist. My father actually was a Rheumatologist and started in the late 50s early 60s and he had Aspirin and Gold to give to people some Indocin and Motrin were big deals back then. Now what we have is -- we have biologically active proteins, it’s like a smart bomb it’s like sitting in a purging golf and sending a bomb that goes down somebody smokes that, a thousand miles away. What we can do now, is we can inject or have the patient inject something underneath their skin and it goes throughout their body and binds up one particular protein, that's causing inflammation and it can make dramatic results for the patient.