Abstract
Anticytokine strategies probably represent the most important breakthrough in the treatment of inflammatory diseases in the last decade. However, blocking the bioactivity of proinflammatory cytokines, crucial activators of host defence, has proved to be accompanied by an increased susceptibility to infections, especially with Mycobacteria, Salmonellae and fungal pathogens. Multiple mechanisms for these side effects have been proposed, such as inhibition of gamma-interferon production, decreased expression of pattern-recognition receptors, and leucocyte apoptosis. Caution is therefore warranted when these treatments are given to patients with an increased risk for infections. A range of side effects other than infection have been reported.
MeSH terms
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Adalimumab
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Anti-Bacterial Agents
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Antibodies, Monoclonal / adverse effects*
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Antibodies, Monoclonal, Humanized
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Antitubercular Agents / therapeutic use
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Arthritis, Rheumatoid / drug therapy
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Drug Therapy, Combination / therapeutic use
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Humans
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Mycobacterium tuberculosis / isolation & purification
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Palatine Tonsil*
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Radiography, Thoracic
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Risk Factors
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Tuberculin Test
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Tuberculosis, Laryngeal / diagnosis
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Tuberculosis, Laryngeal / drug therapy
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Tuberculosis, Laryngeal / microbiology*
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Tuberculosis, Pulmonary / diagnosis
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Tuberculosis, Pulmonary / drug therapy
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Tuberculosis, Pulmonary / microbiology
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Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Substances
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Anti-Bacterial Agents
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Humanized
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Antitubercular Agents
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Tumor Necrosis Factor-alpha
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Adalimumab