Arthritis is a collection of diseases of the joints, generally found among older people. There are several types of arthritis which can occur in almost every joint.
The search for an effective method of treatment of arthritis has been going on for years. Researchers have found various factors which cause arthritis. One of these factors is the Tumor Necrosis Factor or the TNF.
What Happens in Arthritis?
Every joint in the body is made up of the ends of two bones connected with the help of tissues such as cartilage, tendons, ligaments or synovial fluid.Arthritis is a health condition characterized by inflammation of these tissues of the joints.
Arthritis is mainly of two types – Osteoarthritis and rheumatoid arthritis
Wear and tear of the joints cause inflammation which is known as osteoarthritis.
On the other hand, abnormal functioning of the immune system of the body causing degeneration of the tissues present between the joints in rheumatoid arthritis. In this condition, the immune system starts to attack the cells of the body so it is called an autoimmune disease.
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What Is Tumor Necrosis Factor (TNF)?
TNF alpha stands for Tumor Necrosis Factor alpha. It is a protein produced by the immune system of the body. TNF is a part of the cytokines.
What are cytokines?
They are cells involved in the various immune responses of the body. They are responsible for the inflammation in order to heal the injured sites. They can be either pro-inflammatory (inducing inflammation) or anti-inflammatory (reducing the inflammation).
The primary function of the tumor necrosis factor is to initiate death of the cancer causing cells.
So where does the Tumor Necrosis Factor come from?
TNF proteins are made and activated by the white blood cells, mainly macrophages.
Tumor necrosis factor alpha (TNF alpha) is pro-inflammatory in nature.
What is its function?
It induces changes in the body which cause inflammation of the affected part. This is that part of the body into which foreign substances are present.
It helps in curing many diseases of the human body.
Some other functions of TNF alpha are-
- Lipid metabolism – TNF alpha has been found to be involved in the regulation of metabolism of lipids. This includes reduction of the fatty acid uptake and regulation of the cholesterol levels as well.
- Coagulation – Various cytokines including the TNF can influence coagulation in the vascular system.
- Insulin resistance – The tumor necrosis factor alpha is linked with insulin resistance in the blood.
What Role Do They Play In Diseases?
TNF is produced by the body in case the person is suffering from rheumatoid arthritis. In this disease, the tissues of the joint degrade because of a faulty immune system.
TNF increase the level of swelling and pain in the arthritic joint. This further damages the joint.
How does this happen?
The body regulates the amount of TNF alpha in the blood. When a person is healthy, his body automatically stops the production of TNF alpha if they exceed in number. However, in individuals who suffer from an autoimmune disease, this does not happen. This leads to an abnormally increased amount of swelling, which could be harmful.
Tumor necrosis factor has been found to be linked with the development of diseases such as Crohn’s disease, ulcerative colitis, ankylosing spondylitis and even cancer . This is the reason why there is a need for drugs which can counter the harmful effects of this substance.
What Are TNF Inhibitors?
TNF alpha inhibitors are also known as tumor necrosis factor blockers (TNF blockers). They are a type of disease modifying anti rheumatic drugs (DMARDs).
What are DMARDs?
They are medicines given mainly to patients with rheumatoid arthritis for reducing the symptoms of the disease.
They treat the joint and prevent any further damage to the joint.
How do TNF alpha inhibitors work?
They attach to the tumor necrosis factor alpha and prevent it from working and producing inflammation. They treat the inflammation by suppressing it due to its anti-inflammatory effects as well.
This is particularly beneficial in diseases such as rheumatoid arthritis and Crohn’s disease.
How Does TNF alpha inhibitors help Treat Arthritis And Other Diseases?
Most of the common inflammatory diseases can be treated with the use of tumor necrosis factor alpha blockers.
Rheumatoid arthritis – Disease modifying anti-rheumatic drugs (DMARDs) are highly efficacious in treating rheumatoid arthritis. Combination of tumor necrosis factor alpha inhibitors with other DMARDs have shown desired results on the disease. Along with this, they also reduce the risk of cardiovascular disease.
Crohn’s disease – Inflammation of the digestive tract lining along with the bowel is known as the Crohn’s disease. It is a chronic condition; hence it can’t be cured permanently. To reduce the swelling, medicines such as the tumor necrosis factor alpha inhibitors are used.
Ulcerative colitis – Ulcerative colitis is again an inflammatory bowel disease. It is characterized by the formation of ulcers (sore on the lining of the gut) in the colon of the large intestine.
Anti-TNF agents or tumor necrosis factor inhibitors have been found to be very effective in treating the inflammation caused due to an increase in the tumor necrosis factor alpha in the blood. TNF inhibitors heal the damaged mucosal lining of the alimentary canal.
Ankylosing spondylitis – This is a form of arthritis which affects the spine and the hip. The joints of the vertebral column swell and that leads to pain in the chest and lower back.
This inflammation of the joints is due to the tumor necrosis factor. TNF inhibitors block these and help in improving the symptoms of the disease.
Psoriatic arthritis – People who suffer from psoriasis, a health condition in which the skin turns red and patchy with scales, are at a high risk of developing psoriatic arthritis.
It is an autoimmune disease and the major symptoms involve swelling, pain and stiffening of the joints. Using TNF inhibitors leads to an improvement of the disease along with endothelial functioning associated with it.
What Are The Types of TNF Inhibitors?
There are five major types of tumor necrosis factor inhibitors which have been declared safe for their use in the treatment of several health disorders. These drugs have been approved for their TNF inhibiting properties.
Adalimumab – This drug can be found in the market under the trade name of Humira. It works as a medication for inflammatory diseases such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, ulcerative colitis,
Crohn’s disease and psoriasis along with others. It inhibits the action of tumor necrosis factor and controls the swelling. Studies prove that it shows the best results as compared to the four other drugs.
Etanercept – Etanercept is sold under the trade name Enbrel. It treats the autoimmune diseases including rheumatoid arthritis.
Certolizumabpegol – This is the only tumor necrosis alpha inhibitor which is PEGylated. Coagulation of proteins with the help of polyethylene glycol (PEG) is known as their PEGylation. This process causes a reduction in the immunogenicity (ability of the immune system to produce antigens or substances that attack your tissues and infections) and hence blocks the tumor necrosis factor.
Golimumab – It is another approved tumor necrosis factor alpha inhibitor. This drug is an immunosuppressive and has been proven safe for the treatment of rheumatoid arthritis.
Infliximab – It is a monoclonal antibody biologic drug used to cure autoimmune diseases. It does so by working against tumor necrosis factor. Apart from treating rheumatoid arthritis, studies suggest that it improves various heart conditions and abnormalities.
Natural compounds which act as TNF inhibitors.
Turmeric – It is a natural herb which can be cooked with daily meals or can be taken in with milk. It has tumor necrosis factor inhibiting and anti-inflammatory properties because of a chemical substance called curcumin present in it.
Milk thistle – There is a substance present in this plant known as Silymarin. It has anti-inflammatory and anti-cancer properties. It regulates the tumor necrosis factor and other genes involved in inflammation.
Cat’s claw – Studies report that this plant can be used to develop anti tumor necrosis factor alpha properties.
Green tea – It contains a substance known as catechin, which has TNF regulating properties. This can inhibit the inflammation caused in rheumatoid arthritis.
Are There any Side Effects?
Although these drugs have shown positive effects in the treatment of rheumatoid arthritis, the possible side effects should not be ignored. These may include:
What Precautions Must Be Taken?
To avoid the tumor necrosis factor inhibitors from further damaging the body, some precautions need to be taken.
Pregnant women may be at a risk of developing some complications due to a high dosage of TNF inhibitors. This can be harmful for both the mother and the child. Although there is no sufficient proof regarding this, studies recommend avoiding the use of these drugs unless the disease is severe.
Using TNF alpha inhibitors for the treatment of rheumatoid arthritis is a relatively new approach. This has found to effectively cure the disease, although some precautions need to be taken.
However, there can be some serious side effects after the intake of these drugs. A doctor should be consulted regularly while taking the TNF alpha blockers.
Natural treatment methods still remain the best option for treating arthritis.