TNF in immune system
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Rheumatoid arthritis (RA), juvenile rheumatoid arthritis (JRA), ankylosing spondylitis (AS), psoriatic arthritis, and psoriasis are all diseases involving the immune system.
In these diseases, the immune system attacks the body’s own cells. In the cases of RA, JRA, AS, and psoriatic arthritis, the results can be pain, swelling, stiffness in the joints, and fatigue. In the case of psoriasis, episodes of inflammation can include redness, itching, and thick, dry, silvery scales on the skin.
Tumor necrosis factor, or TNF, is one of the chemical messengers that helps regulate the inflammatory process. During a normal immune response, TNF attaches to certain cells. This "switches on" immune cells, causing them to release chemicals that can increase inflammation. When people produce too much TNF, it overwhelms the immune system's ability to control inflammation.
TNF alpha is produced mostly by macrophages in response to infection by bacteria and other pathogens. TNF promotes the production of more cytokines including IL-1. TNF will enhance the stimulation of T and B cells and other immune system cells to make a response to antigenic challenge more potent.
As the name suggests TNF has anti tumor properties. Its ability to increase the activity of T cells is important in tumor destruction but it also has a selective affect on the blood system in tumors reducing the production of blood vessels and effectively helping to slow down or even reverse tumor growth by starving the cancer cells of the large amounts of nutrients they require for the continuous cell division.
However, the properties of TNF can also be a disadvantage too. TNF can adversely affect endothelial cells that make up blood vessel walls. This may be good in combating tumors but bad for healthy tissue. Endothelial cells normally have anticoagulant properties. However, TNF promotes blood clotting and constriction of blood vessels with subsequent restriction of the blood flow. TNF may also promote adherence of some immune system cells to the surface of blood vessels and cause production of oxygen radicals which destroy the blood vessel and surrounding tissue.
For people with many rheumatic diseases, the synovial membrane—the lining of the joints can become inflamed. When this happens, the inflamed cells and fluid in the joint begin to destroy joint cartilage. This process causes pain and inflammation.
A similar process leads to the excessive skin growth, flaking, and itching of psoriasis. Researchers have discovered that people with psoriasis often have increased levels of TNF in their affected skin areas. These increased levels of TNF can overwhelm the immune system's ability to control the inflammation of psoriasis. Many other conditions are characterized by an excess of TNF.
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