Targets of anticytokine therapy and the risk of infections in humans and mice

Esther Van De Vosse*, Michiel A. Van Agtmael

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

PURPOSE OF REVIEW: To examine the type and risk of infections in humans and mice deficient in proinflammatory cytokines. Naturally occurring or manipulated genetic defects of tumor necrosis factor, interleukins-1, -6, -12, and -15, and interferon-γ are examined for their increased susceptibility to, or protection from, infection. RECENT FINDINGS: Interleukin-12p40 and interferon-γ-blockers may lead to increased incidence of infections with intracellular bacteria, parasites, and fungi. In addition, we may see viral infections with interferon-γ-blockers. Increased risk of infections is unlikely with either interleukin-1- or interleukin-15-blockers. Interleukin-6-blockers may lead to increased risk of infection with extracellular bacteria, viruses, parasites and fungi. SUMMARY: In tumor necrosis factor knockout mice, increased susceptibility to pathogens are reported that are normally controlled by granuloma formation. In patients treated with tumor necrosis factor-blockers, a two-fold increase of granulomatous infections, predominantly reactivation of latent tuberculosis, is found. The infections detected in tumor necrosis factor knockout mice were accurate for predicting the infections observed when using tumor necrosis factor-blockers. If a similar correlation exists for other cytokines, the use of interferon-γ and interleukin-12p40 blockers, and possibly interleukin-6 blockers, will lead to an increased risk for severe infections. Care should be taken when new cytokine blockers/antagonists are introduced.

Original languageEnglish
Pages (from-to)626-635
Number of pages10
JournalCurrent Opinion in Rheumatology
Volume19
Issue number6
DOIs
Publication statusPublished - Nov 2007

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