The alternate effects of anti-TNF therapeutics and their role in mycobacterial granulomatous infection in Crohn's disease

作者：Qasem Ahmad; Naser Abed Elrahman; Naser Saleh A^*

来源：Expert Review of Anti-Infective Therapy, 2017, 15(7): 637-643.

DOI：10.1080/14787210.2017.1328276

• Anti-TNF
• Crohn's disease
• cytokines
• granuloma
• MAP
• mycobacterium paratuberculosis
• RHB-104
• TNF

Introduction: Crohn's disease is an inflammatory bowel disease that has been debated to be associated with bacterial triggers such as Mycobacterium avium subspecies paratuberculosis (MAP). Standard treatment of Crohn's disease (CD) patients includes a family of immunomodulators and biologics such as Anti-Tumor Necrosis Factor alpha (Anti-TNF). This cytokine in particular has been known to play vital roles in fighting microbial infections through formation and maintenance of granulomas.Areas covered: This perspective is focused on elucidating the negative effects of using Anti-TNF therapeutic agents as a treatment option in CD patients who are more likely suspected to have MAP infection, and the role of other immunomodulators in MAP infection.Expert commentary: While treatment with Anti-TNF is beneficial to reduce inflammation and to provide short term relief to the patients, it also compromises the immune system causing susceptibility to microbial infection. More than 50% of CD patients have shown no response to Anti-TNF treatment which indicates a demand for introducing novel CD treatment in combination with antibiotics as a future CD treatment plan.

• 出版日期2017