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Complications of TNF-α antagonists and iron homeostasis
Citation:
GHIO, A. J. AND E. Weinberg. Complications of TNF-α antagonists and iron homeostasis. MEDICAL HYPOTHESES. Harcourt Publishers Limited, Kent, Uk, 78(1):33-5, (2012).
Impact/Purpose:
Despite a beneficial effect, the use of TNF-α antagonists is associated with an increased risk for infections and neoplasms; the basis for these complications is unclear.
Description:
TNF-α is a central regulator of inflammation and its blockade downregulates other proinflammatory cytokines, chemokines, and growth factors. Subsequently, TNF-α antagonists are currently used in treatment regimens directed toward several inflammatory diseases. Despite a beneficial effect, the use of TNF-α antagonists is associated with an increased risk for infections and neoplasms; the basis for these complications is unclear. The cytokine also participates in iron homeostasis and the sequestration of this metal, mediated by TNF-α, is considered protective. It is proposed that treatment with TNF-α antagonists negates a protective response, reverses the sequestration of host iron, increases the available concentrations of this metal, and predisposes the patient to infections and neoplasms. It is recommended that patients who are to receive TNF-α antagonists be tested for iron overload and the use of these agents in those individuals with excess iron should be reconsidered.
