The proinflammatory cytokine TNF- plays an important role in the pathogenesis of a number of chronic inflammatory disorders, such as rheumatoid arthritis, juvenile rheumatoid arthritis, Crohn's disease, Behçet's disease, psoriatic arthritis, psoriasis, sarcoidosis, systemic lupus erythematosus, and ankylosing spondylitis (Goffe and Cather 2003; Nickoloff and Stevens 2006). Overproduction of TNF-a can lead to chronic inflammation and tissue damage, and a number of other adverse effects on various cell types (Table 4.2) (Goffe and Cather 2003).
Etanercept modulates biological responses that are initiated or controlled by TNF-a (Table 4.3) (Goffe and Cather 2003; Kavanaugh 2005). This section will review the pharmacodynamics of etanercept, the mechanisms of action, and the resulting biochemical and physiologic effects of the drug.
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