Rheumatoid Arthritis Advance May Be Relevant to AIDS

Researchers in London have reported impressive results in
treating rheumatoid arthritis with a monoclonal antibody against
tumor necrosis factor (TNF). Initial results of the trial,
conducted by T. Miani and M. Feldman, were published in the
February issue of Arthritis and Rheumatism. We could not obtain
the article by press time, but according to media reports,
patients received only two weeks of treatment and consistently
experienced improvement for three to five months. Continuing
treatment appears to be successful so far.
One of the researchers provided current information in a
recent radio interview on the BBC (British Broadcasting
Corporation). About 50 volunteers have now been treated,
apparently with success in every case. All of them had failed
standard treatments for rheumatoid arthritis, in order to be
eligible for the study. The researchers had been concerned that
the patients might become more susceptible to infections, since
TNF has a normal role in immune defenses; but no such problem was
found.

How is this relevant to AIDS? Tumor necrosis factor (TNF),
which is found naturally in the body, is often too high in people
with HIV or AIDS. It is believed to be an important cause of
wasting syndrome. Also, it can stimulate HIV growth directly;
for example, in our article on LTR inhibitors (AIDS TREATMENT
NEWS #192, February 4, 1994), TNF was the agent used in the
laboratory to stimulate the HIV LTR, in order to screen for
potential LTR inhibitors.

Two drugs currently being tested as a potential AIDS
treatment -- pentoxifylline, and thalidomide -- reduce the levels
of TNF in the body. The monoclonal antibody (which is produced
by Centocor, a Philadelphia company, although it was tested in
the UK) may be a highly effective way to block TNF. While this
particular drug will not be widely available for some time, the
dramatic results in the arthritis study, if confirmed, may
advance the research on other drugs with a similar mechanism of
action.