Tumor Necrosis Factor (TNF) and Rheumatoid Arthritis

Tumor necrosis factor (TNF) is a substance produced by cells in your immune system that has many effects in promoting the inflammatory process. It is produced chiefly by macrophages, a type of white blood cell, but can be produced by other cells as well.

Tumor Necrosis Factor in the Immune Response

TNF is a natural part of the body's immune response to tumor cells, bacteria, and viruses. It plays a part both in acute reactions and systemic inflammation. Cells release it when they detect a specific substance (an antigen) to which they have become sensitized.

TNF is a cytokine, a signaling protein. Cytokines are chemical substances which deliver messages between cells in the body. They play a part in many biological processes, including:

  • Cell proliferation
  • Apoptosis, the normal process of the death of a cell
  • Lipid (fat) metabolism
  • Coagulation, or formation of blood clots

Tumor Necrosis Factor in Disease

TNF may be produced in excess or inappropriately in different disease processes. This can result in ongoing inflammation and other destructive symptoms. These diseases include:

Rheumatoid Arthritis

Tumor necrosis factor-alpha is one of the most important cytokines involved in rheumatoid arthritis through its entanglement in the cascade of inflammatory reactions. Normally, the body blocks excess TNF naturally. But in rheumatic disease, it stays active and creates more inflammation. TNF blocker drugs were developed to control this inflammatory response.

TNF Inhibitor Drugs

People with health conditions such as rheumatoid arthritispsoriatic arthritis, and Crohn's disease may be treated with TNF inhibitor drugs. These drugs bind to tumor necrosis factor-alpha, rendering it inactive. This interferes with inflammatory activity and suppresses your immune system. For people with rheumatoid arthritis, this can decrease joint damage. The first drug was approved in 1998 and more have been developed. They are in the class of biologic drugs, which are medications that target molecules on cells of the immune system.

Using TNF Inhibitors

TNF blockers are not taken orally. Instead, you must inject them under your skin or into your vein, usually in your thigh or abdomen. According to patient reports, changes in your symptoms begin to occur after two or three doses.

If your doctor prescribes an injectable TNF blocker, you will be taught how to inject it yourself so you won't have to go to the doctor's office each time.

If your doctor prescribes infliximab or golimumab, you will have to go to an infusion center or a doctor's office for up to three hours to receive your treatment. These drugs are not injectable.

Side Effects

TNF blockers can cause side effects. The most common is an injection site reaction, which is usually a localized rash accompanied by a burning sensation or itching.

An increased risk of all types of infections is the most significant side effect of TNF blockers because they suppress your immune system. Make sure your doctor tests you for tuberculosis and hepatitis B before starting treatment.

Was this page helpful?

Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.