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4. Explain why anti-TNF treatment increases susceptibility to tuberculosis

4. Explain why anti-TNF treatment increases susceptibility to tuberculosis. The life of many individuals with inflammatory diseases such as rheumatoid arthritis has been dramatically improved by treatment with drugs that target the protein TNF, so called anti-TNF therapies.

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4. Explain why anti-TNF treatment increases susceptibility to tuberculosis

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  1. 4. Explain why anti-TNF treatment increases susceptibility to tuberculosis

  2. The life of many individuals with inflammatory diseases such as rheumatoid arthritis has been dramatically improved by treatment with drugs that target the protein TNF, so called anti-TNF therapies. • However, anti-TNF therapies can decrease the ability of the immune system to fight infections and have been associated with an increased incidence of tuberculosis.

  3. A subset of CD8-expressing effector memory immune T cells characterized by expression of the proteins CD45RA and granulysin or CD45RA+ effector memory CD8+ T cells were identified as having a major role in targeting the bacterium that causes tuberculosis (Mycobacterium tuberculosis).

  4. Furthermore, numbers of CD45RA+ effector memory CD8+ T cells were reduced in patients following treatment with anti-TNF drugs such as infliximab. • As this is correlated with a decreased ability of peripheral blood from the patients to kill M. tuberculosis, it can be that the loss of this immune cell subset provides a mechanism to explain the reactivation of latent tuberculosis infection in some individuals being treated with this drug.

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