Tumour necrosis factor (TNFα) is a cytokine with a wide range of diverse and at times paradoxical effects. Theseinclude immunoregulatory,lymphoid organogenesisand pro-inflammatory effects. In recent years, TNFα has become a focus of interest more for its inflammatory effects in a number of chronic autoimmune diseases. This interest culminated in the successful treatment of patients with rheumatoid arthritis, Crohn's diseases and ankylosing spondylitis with blocking antibodies or soluble TNFα receptors. Paradoxically, however, TNFα also has immunomodulatory effects in some autoimmune conditions such as lupus in some mouse models of the disease and in diabetes in the none-obese diabetic mouse. The role TNFα plays in human systemic lupus erythematosus is, however, controversial. In this article we review some of the studies carried out to elucidate the effects of TNFα in lupus disease and likely mechanisms of action. Further, we discussrecent data on the likely effects of blocking TNFα on anti-DNA autoantibody production.
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