Cytokines and How They Work

In This Article

Cytokines are proteins produced by cells that serve as molecular messengers between cells. In arthritis, cytokines regulate various inflammatory responses. As part of the immune system, cytokines regulate the body's response to disease and infection, as well as mediate normal cellular processes in your body.

A man rubbing his shoulder
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Types of Cytokines

Cytokines are diverse, meaning they are not all alike. Cytokines serve various functions in the body. They:

  • Stimulate the production of blood cells
  • Aid in the development, maintenance, and repair of tissues
  • Regulate the immune system
  • Drive inflammation through interferons, interleukins, and tumor necrosis factor-alpha (TNFα)

While "cytokines" is an umbrella term that includes all kinds, more specific names are given to cytokines based on either the type of cell that makes them or the action they have in the body:

  • Lymphokines, which are made by lymphocytes
  • Monokines, which are made by monocytes
  • Chemokines, which are associated with chemotactic actions
  • Interleukins, which are made by one leukocyte but act on other leukocytes

How They Work

The immune system is complex—different types of immune cells and proteins do different jobs. Cytokines are among those proteins. To understand inflammation, you must understand the role cytokines play.

Cells release cytokines into your blood circulation or directly into tissues. The cytokines locate the immune cells they're designed to target and binding to the cell's receptors. This interaction triggers or stimulates specific responses by the target cells.

Overproduction

Overproduction or inappropriate production of certain cytokines by the body can result in disease.

For example, interleukin-1 (IL-1) and (TNFα) are produced in excess in rheumatoid arthritis, where they're involved in inflammation and tissue destruction.

Biologic Cytokine Inhibitors

Some biologic drugs inhibit IL-1 or TNFα.

Kineret (anakinra) works by inhibiting the binding of IL-1 to its receptor. Actemra (tocilizumab) and Kevzara (sarilumab) bind IL-6.

TNFα inhibitors (also called TNF blockers) bind to TNF and prevent it from attaching to cell surface receptors. TNFα inhibitors on the market are:

Cytokine Basics

Proinflammatory cytokines play a role in the development of inflammatory and neuropathic pain.

Anti-inflammatory cytokines are actually inflammatory cytokine antagonists.

Evidence suggests that chemokines are involved in initiating pain and in the persistence of pain. 

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  1. Ferreira VL, Borba HH, Bonetti ADF, Leonart LP, Pontarolo R. Cytokines and Interferons: Types and FunctionsAutoantibodies and Cytokines. 2019. doi:10.5772/intechopen.74550

  2. Tisoncik JR, Korth MJ, Simmons CP, Farrar J, Martin TR, Katze MG. Into the eye of the cytokine stormMicrobiol Mol Biol Rev. 2012;76(1):16–32. doi:10.1128/MMBR.05015-11

  3. Zhang JM, An J. Cytokines, inflammation, and painInt Anesthesiol Clin. 2007;45(2):27–37. doi:10.1097/AIA.0b013e318034194e

Additional Reading
  • Cytokines. BioBasics.

  • McInnes I. and Schett G. Cytokines in the pathogenesis of rheumatoid arthritis. Nature Immunology.

  • Regeneron and Sanofi Present Results from Pivotal Phase 3 Study of Sarilumab at American College of Rheumatology Annual Meeting. Regeneron.

  • Zhang, J-M et al. Cytokines, Inflammation and Pain. International Anesthesiology Clinics.

  • Growth Factors and Cytokines. Primer on the Rheumatic Diseases. Edition 12. Published by the Arthritis Foundation.