TNF-α
Ligand for TNFR1 — upstream trigger
- Expression
- Elevated during attacks
- Evidence level
- established
- Targeted by
- Etanercept (partial)
Role in pathogenesis
TNF-α is the principal ligand for TNFR1. In TRAPS, autocrine TNF secretion and wild-type TNFR1 on the cell surface amplify inflammation. Paradoxically, anti-TNF monoclonal antibodies (infliximab) can worsen disease, while soluble receptor mimetic etanercept has partial efficacy.
Targeting drugs (1)
| Drug | Mechanism | Response | Line |
|---|---|---|---|
| Etanercept | Soluble TNF receptor fusion protein (TNFR2-Fc) | Partial, waning over time | Alternative |