Tumor necrosis factor alpha (TNF-α) was initially recognized as a factor that causes the necrosis of tumors, but it has been recently identified to have additional important functions as a pathological component of autoimmune diseases. TNF-α binds to two different receptors, which initiate signal transduction pathways. These pathways lead to various cellular responses, including cell survival, differentiation, and proliferation. However, the inappropriate or excessive activation of TNF-α signaling is associated with chronic inflammation and can eventually lead to the development of pathological complications such as autoimmune diseases. Understanding of the TNF-α signaling mechanism has been expanded and applied for the treatment of immune diseases, which has resulted in the development of effective therapeutic tools, including TNF-α inhibitors. Currently, clinically approved TNF-α inhibitors have shown noticeable potency in a variety of autoimmune diseases, and novel TNF-α signaling inhibitors are being clinically evaluated. In this review, we briefly introduce the impact of TNF-α signaling on autoimmune diseases and its inhibitors, which are used as therapeutic agents against autoimmune diseases.

Apoptosis, necrosis, and pyroptosis: The routes to cell death are many, and distinguishing which path a particular cell may have taken remains a challenge. Wallach et al. review current understanding of how programmed necrotic cell death contributes to inflammation. Science , this issue p. 10.1126/science.aaf2154

Knockout of caspase-8, a cysteine protease that participates in the signaling for cell death by receptors of the TNF/nerve growth factor family, is lethal to mice in utero. To explore tissue-specific roles of this enzyme, we established its conditional knockout using the Cre/loxP recombination system. Consistent with its role in cell death induction, deletion of caspase-8 in hepatocytes protected them from Fas-induced caspase activation and death. However, application of the conditional knockout approach to investigate the cause of death of caspase-8 knockout embryos revealed that this enzyme also serves cellular functions that are nonapoptotic. Its deletion in endothelial cells resulted in degeneration of the yolk sac vasculature and embryonal death due to circulatory failure. Caspase-8 deletion in bone-marrow cells resulted in arrest of hemopoietic progenitor functioning, and in cells of the myelomonocytic lineage, its deletion led to arrest of differentiation into macrophages and to cell death. Thus, besides participating in cell death induction by receptors of the TNF/nerve growth factor family, caspase-8, apparently independently of these receptors, also mediates nonapoptotic and perhaps even antiapoptotic activities.

Mice deficient in caspase-8, FADD, or cFLIP, present defects in yolk sac vascularization and embryonic lethality at E10.5. Ablation of RIPK3, a kinase that promotes a form of necrotic cell death, has recently been shown to rescue embryonic lethality in caspase-8 deficient animals. Here we show that while FADD, RIPK3 double knockouts develop normally, the lethal effects of cFLIP deletion are not rescued by RIPK3 deficiency. Remarkably, embryos lacking FADD, cFLIP, and RIPK3 develop normally. Distinct regions of apoptosis were observed in E9.5 FLIP, RIPK3 double knockout embryos, but not in caspase-8−/− or FADD−/− embryos. In vitro studies using death receptor stimulation show that the FADD-caspase-8-cFLIPL complex blocks RIPK3-dependent necrosis, while cFLIPL blocks RIPK3-independent apoptosis promoted by the FADD-caspase-8 complex. Together, these results suggest the cross-regulation of two distinct processes in development and death-receptor signaling: RIPK3-dependent signaling (including necrosis) controlled by the enzymatic activity of the FADD-caspase-8-cFLIPL complex, and cFLIPL control of RIPK3-independent apoptosis by FADD-caspase-8.