Saturday, 19 November 2016

Anti-TNF makes MS worses

Alnasser Alsukhni R, Jriekh Z, Aboras Y. Adalimumab Induced or Provoked MS in Patient with Autoimmune Uveitis: A Case Report and Review of the Literature.Case Rep Med. 2016;2016:1423131

Anti-tumor necrosis factor α (anti-TNF-α) agents have been widely used in the field of autoimmune diseases and have proved decisive efficacy and relative safety. Data concerning their adverse effects has been lately describing central nervous system (CNS) demyelination process at escalating basis. Case Presentation. A 23-year-old male with autoimmune uveitis and a family history of multiple sclerosis (MS) developed two neurological attacks, after Adalimumab infusion, simultaneously with several cerebral lesions on magnetic resonance imaging (MRI). Hence the diagnosis of Adalimumab induced MS was suspected. Conclusion. This case is reported to tell physicians to be cautious when using anti-TNF-α in patients with family history of MS and to reconsider the risk of MS in patients with autoimmune diseases.


Tumor necrosis factor is a cytokine that can kill tumors but it can do other things as well. A chap called sir Marc Feldmann got the patent for treatment of rheumatoid arthritis with anti-TNF. He and his clinical colleague Tiny Maini were the first scientists to take an idea to control autoimmunity from the bench into the clinic. His first drug called infliximab made some people a mint. I filed the patent with Sir Marc for use of anti-TNF in treating MS. Marc got Knighted and minted for arthritis studies but as anti-TNF was found to make MS worse this is a dead end and I wont get as much as a jelly baby let alone a mint. Adalimumab is a human anti-TNF and it too can cause demyelinating disease.

This is telling us something about MS. What is it?

11 comments:

  1. "I will tell you very soon".

    Just get on with it man. You've spent 30 years researching this disease with little to shout about so actally tell us some good news. We don't want the who-done-it rubbish or your Mickley mouse advent calendar tosh. Don't hide behind the "waiting for publication in a journal" rubbish. Prof G must be abroad on a jolly as he would have stopped you posting a blog with a teasing line at the end.

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    Replies
    1. Ha! Don't forget his White Knight thing.

      I hate the mouse advent stuff too. It's rubbish.

      Delete
    2. I prefer the big M myself

      However, what about the white knight thing?

      From where I am sitting it appears that it has produced an option for people who would otherwise slip through the net.

      Is that a failure?

      Delete
    3. MouseDoc, I think you're a good scientist. The advent calendar is lame, though. It sources no purpose.

      The White Knight thing I just don't understand.

      Delete
    4. Read the post on 25 Decembrer 2015 it was all explained

      The original purpose was to advertise the Research Day,
      We are not organising one next year, maybe it is Neurology turn,
      I'm not sure.

      Delete
    5. P.S. Reasd below should we disappoint the Children?

      Delete
  2. He's busy with his anniversary:-)....So you cant cope with a bit of suspense so I've removed it as you do need to wait until it's published.

    Anyway ebineezer thanks for the reminder. My tailor is back in business at the House of Mouse and made a new set of outfits.So advent calendar is a possibility.

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    Replies
    1. Yes! Bring on the rodents please! my children love your advent calendars!

      Delete
  3. MD I think that negative studies in MS are just as important as the positive studies and appreciate the post. My simple understanding is that anti-TNF inhibitors in other diseases block macrophages, mast cells and T-cell response by blocking T-helper cells. If this is correct, I am not sure why this would not help RRMS and worsen the situation? Does it block or change microglia (macrophages of the CNS) as well?

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    Replies
    1. I totally agree the negative studies are useful.

      The button is pressed this week the time to answer depends on reviwers, hope it doesnt take a year or more:-(

      Delete
  4. Is it because, as for example an anti TN alpha like Infliximab, Adalimumab can lead to the potential EBV driven autoimmune lymphoproliferative phenomena, particularly in genetically predisposed patients?

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