Journal Mobile

GM Raftery, DJ Armstrong
Journal Issue: 
Volume 38: Issue 2: 2008




Tumour necrosis factor alpha (TNF a) has emerged as one of the key cytokines  in  the  fields  of  infection  and  inflammation,  and  has  been  linked  with disease  activity  and  joint  damage  in  rheumatoid  arthritis.  Acute  myocardial infarction remains the leading cause of death in rheumatoid arthritis, and there is now a large body of evidence placing TNF a and other inflammatory cytokines at the  centre  of  the  development  of  atherosclerotic  plaques  and  their  subsequent rupture, which is in keeping with the observation of accelerated atherosclerosis in rheumatoid arthritis patients. TNF a might also have a role to play in the increased incidence of congestive cardiac failure seen in rheumatoid arthritis. Although anti-TNF a therapies were originally developed with a view to controlling joint disease in rheumatoid arthritis, evidence is emerging of a positive benefit in reducing  heart  disease  as  well. A  range  of  mechanisms  has  been  suggested  by which anti-TNF a treatment might achieve a reduction in incidence of myocardial infarction  and  cardiac  failure,  some  of  which  will  have  implications  for  the treatment of cardiovascular disease in general.