Submitted on July 24, 2006
Revised on January 2, 2007
Accepted on January 2, 2007
The role of TNF
in chronic inflammatory conditions, intermediary metabolism and cardiovascular risk
Calin Popa, Mihai G. Netea, Piet L. C. M van Riel, Jos W. M van der Meer, and Anton F. H. Stalenhoef
General Internal Medicine (463) and Rheumatology (470), Radboud University Nijmegen Medical Centre, Nijmegen 6525 GA
Corresponding Author: c.popa{at}aig.umcn.nl
The recent insight that inflammation contributes to the development of atherosclerosis and type 2 diabetes mellitus constitutes a major breakthrough in understanding the mechanisms underlying these conditions. In addition, it opens the way for new therapeutic approaches that might eventually decrease the prevalence of these public health problems. TNFa has been shown to play a key role in these processes and thus might be a potential therapeutic target. Increased concentrations of TNFa are found in acute and chronic inflammatory conditions (e.g. trauma, sepsis, infection, rheumatoid arthritis), in which a shift towards a pro-atherogenic lipid profile and impaired glucose tolerance occurs. While therapeutical blockade of TNFa worsens the prognosis in patients with abscesses and granulomatous infections, this strategy is highly beneficial in the case of chronic inflammatory conditions including rheumatoid arthritis. Current investigations assessing the impact of anti-TNF agents on intermediary metabolism suggest that TNFa blockade may improve insulin resistance and lipid profiles in patients with chronic inflammatory diseases.
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