Free radicals and endothelial dysfunction: Potential positive effects of TNF-α inhibitors

OBJECTIVES: During the last decade many new biological immune modulators have entered the market as new therapeutic principles. Tumor necrosis factor (TNF)-α is a pro-inflammatory cytokine known to a have a key role in the pathogenic mechanisms of various immune-mediated or inflammatory diseases. However, TNF-α also plays a key role in endothelial dysfunction and, thus, in the development and progression of atherosclerosis. What, then, is the potential therapeutic role of TNF-α inhibitors? METHODS: We analysed the current literature concerning the administration of TNF-α inhibitors and their potential benefits upon endothelial function. RESULTS: TNF-α inhibitors decrease the serum levels of inflammatory markers such as TNF-α itself, CRP, IL-6, and increased the tissue expression of endothelial NO synthase and the vasodilatory response to bradykinin. DISCUSSION: TNF-α inhibitors may change the progression of endothelial dysfunction and, thus, slow down the atherosclerotic process.