Anti-tumour necrosis factor-α therapy in heart failure: Future directions

Abstract

The elevated level of tumour necrosis factor-α (TNF-α) in patients with heart failure has triggered interest in investigating the role of TNF-α in the pathogenesis of heart failure. Both clinical and experimental evidence has suggested that high levels of TNF-α occur in heart failure and lead to progression of left ventricular dysfunction. In addition, it has been documented that inhibition of TNF-α reverses its deleterious effects in heart failure. A number of clinical trials have been initiated to investigate the effect of anti-TNF-α therapy in patients with heart failure. The discouraging results of recent clinical trials of anti-TNF-α therapy in patients with heart failure have raised a number of questions about the role of TNF-α in heart failure. The present review critically analyzes the reasons of failure of anti-TNF-α therapy in heart failure. Moreover the potential approaches for the development of new anti-TNF-α therapy has been discussed which may open new vista of the management of heart failure. © Basic & Clinical Pharmacology & Toxicology 2006.