Eternacept acts by one of the following mechanisms?

Ans is 'a' i.e., By blocking tumor necrosis factor BIOLOGIC RESPONSE MODIFIER (BRMs1 o Several recombinant proteins/monoclonal antibodies that bind and inhibit cytokines, especially TNFa or IL-I have been used succesfully in autoimmune diseases like RA, IBD, psoriosis or scleroderma. A. TNF-a inhibitors a. Etanercept o It is a recombinant fusion protein of TNF - receptor and Fc poion of human IgG1. o It is administered by S.C. injection. b.Infliximab o It is a chimeral monoclonol antibody which binds and neutralizes TNF-alpha. o It is given by i.v. route. o It is indicated in RA, psoriotic ahritis, Crohn's disease, Wegener's granulomatosis and sarcoidosis. c. Adalimumab o This recombinant monoclonal anti-TNF antibody. o It is administered by S.C. route. B. IL,-1 antagonist Anakinra o It is a recombinant human IL-I receptor antagonist. o It is less effective than TNF inhibitors. o It is administered by S.C. route. C. T-cell costimulatory blockers Abatacept o It is a fusion protein that combines the extracellular domain of the molecule CTLA4 (CD 154) with the Fe poion of a human immunoglobulin. o It interfere with the interactions between antigen presenting cells and T lymphocytes. Therefore, it affects early stages in the pathogenic cascade of event in RA. D. B-cell depicters Rituxintab o B-cells are inflammatory cells with multiple functions in the immune response. The depletion of B cells has been shown to be effective in reducing signs and symptoms of RA and in slowing radiographic progression. o Rituximab is a chimeric monoclonal antibody that binds to the CD20 molecule on the B cell surface leading to the removal of B cells from the circulation.