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)-alpha 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-alpha 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-alpha inhibitors? Methods: We analysed the current literature concerning the administration of TNF-alpha inhibitors and their potential benefits upon endothelial function. Results: TNF-alpha inhibitors decrease the serum levels of inflammatory markers such as TNF-alpha itself, CRP, IL-6, and increased the tissue expression of endothelial NO synthase and the vasodilatory response to bradykinin. Discussion: TNF-alpha inhibitors may change the progression of endothelial dysfunction and, thus, slow down the atherosclerotic process.