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Am J Physiol Gastrointest Liver Physiol 296: G612-G620, 2009. First published January 8, 2009; doi:10.1152/ajpgi.90576.2008
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INFLAMMATION/IMMUNITY/MEDIATORS

Infliximab and the TNF-{alpha} system

Ellen C. Ebert

University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey

Submitted 4 October 2008 ; accepted in final form 28 December 2008

Infliximab, a chimeric monoclonal antibody against TNF-{alpha}, is efficacious in Crohn's disease (CD) and rheumatoid arthritis (RA). Its main mechanism of action is thought to be the induction of apoptosis. The present study evaluates in detail the effects of infliximab on the TNF-{alpha} system using peripheral blood monocytes and T cells as well as lamina propria lymphocytes from normal individuals and patients with CD, ulcerative colitis, and RA. Lymphocytes were studied in the resting state in the absence of strong stimuli that may obscure subtle findings. Infliximab did not change the numbers of viable cells. Rather, it caused monocytes to increase their release of soluble TNFR2, which serves to neutralize TNF-{alpha}, potentiating the action of infliximab. It reduced TNFR2 expression, thereby decreasing TNF-{alpha} responsiveness. These changes were due to upregulated production of TNFR2 rather than increased shedding. Infliximab did not cause rebound production of TNF-{alpha} transcripts that would counteract its effects. It specifically enhanced production of IL-10 but not proinflammatory cytokines secreted by leukocytes, thereby promoting an anti-inflammatory microenvironment. In addition, infliximab caused a rise in c-Jun amino-terminal kinase phosphorylation by monocytes. Thus infliximab manipulates the TNF-{alpha} system to promote its anti-TNF-{alpha} effects.

anti-TNF; lamina propria lymphocytes; macrophages; mucosal immunology


Address for reprint requests and other correspondence: E. C. Ebert, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08903 (e-mail: ebertec{at}umdnj.edu)






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