The effects of TNF-alpha inhibition on cartilage: a systematic review of preclinical studies

Abstract

Objective: To report the most up-to-date evidence on the effects of tumour necrosis factor (TNF)-alpha inhibition on cartilage with a focus on its clinical relevance. Design: A systematic review was performed by searching PubMed, Embase and Cochrane Library databases. Inclusion criteria were studies of any level of evidence published in peer-reviewed journals reporting clinical or preclinical results written in English. Relative data were extracted and critically analysed. PRISMA guidelines were applied, and risk of bias was assessed as well as the methodological quality of the included studies. Results: 13 studies were included after applying the inclusion and exclusion criteria. Three were in vitro human studies from osteoarthritis (OA) patients. Ten were animal modal studies including two in vitro studies, and eight in vivo studies. TNF-alpha inhibition in in vitro studies was generally reported beneficial due to the improved osteochondral viability, proliferation and chondrogenesis. In addition, TNFalpha inhibition was noted to be beneficial in promoting the natural repair of osteochondral lesions and has a chondroprotective effect in in vivo studies. Conclusion:Based on current evidence, TNF might have the potential to interfere with the healing process of chondral and osteochondral defects occurring naturally or in low inflammatory environment after a cartilage repair procedure. Therefore, the use of biological agents to inhibit its action in cartilage repair surgery could be beneficial, and this could translate into a promising therapy that improves the outcome of currently available cartilage procedures.

Blocking TNFα attenuates progressive cartilage matrix degradation in inflammatory arthritis

“…The present study demonstrated that TNFα contributed to OA pathogenesis via NF-κB mechanisms affecting metabolic imbalance in chondrocytes, leading to structural joint damage (39). Similarly, it was recently demonstrated that patients with OA exhibited a notable response to anti-TNF therapy (40), indicating a pivotal role for TNFα in cartilage catabolism. Thus, TNF inhibitors may be a therapeutic option for patients with OA with severe inflammation or TNFα-driven cartilage destruction.…”

Pulsed Electromagnetic Field Attenuates Osteoarthritis Progression in a Murine Destabilization-Induced Model through Inhibition of TNF-α and IL-6 Signaling

“…[3][4][5] A systematic review of preclinical studies suggests that TNF-α inhibition promotes cartilage repair in both in vivo and in vitro OA models. 6 There is also evidence to suggest that IL-6 inhibition 7 or knockout (KO) 8 alleviates knee OA cartilage destruction in mice. TNF-α and IL-6 have been shown to induce chondrocyte apoptosis in OA 7,9 and have become a prominent treatment target for OA.…”

Cytokine status in posttraumatic synovitis on the background of systemic and intra-articular use of NSAID and ozone

“…На фоне длительно сохраняющегося провоспалительного потенциала тканей сустава про-исходит значительное снижение репаративных процессов, что в конечном итоге приводит к дезорганизации внеклеточного матрикса и прогрессирующей дезинтеграции хряща в совокупности с другими дегенеративно-дистрофическими внутрисуставными изменениями [9,11].…”