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1.
Sci Immunol ; 7(78): eade5728, 2022 12 23.
Artículo en Inglés | MEDLINE | ID: mdl-36525507

RESUMEN

Interleukin-1 (IL-1) family cytokines are key barrier cytokines that are typically expressed as inactive, or partially active, precursors that require proteolysis within their amino termini for activation. IL-37 is an enigmatic member of the IL-1 family that has been proposed to be activated by caspase-1 and to exert anti-inflammatory activity through engagement of the IL-18R and SIGIRR. However, here we show that the longest IL-37 isoform, IL-37b, exhibits robust proinflammatory activity upon amino-terminal proteolysis by neutrophil elastase or cathepsin S. In sharp contrast, caspase-1 failed to process or activate IL-37 at concentrations that robustly activated its canonical substrate, IL-1ß. IL-37 and IL-36 exhibit high structural homology, and, consistent with this, a K53-truncated form of IL-37, mimicking the cathepsin S-processed form of this cytokine, was found to exert its proinflammatory effects via IL-36 receptor engagement and produced an inflammatory signature practically identical to IL-36. Administration of K53-truncated IL-37b intraperitoneally into wild-type mice also elicited an inflammatory response that was attenuated in IL-36R-/- animals. These data demonstrate that, in common with other IL-1 family members, mature IL-37 can also elicit proinflammatory effects upon processing by specific proteases.


Asunto(s)
Interleucina-1 , Péptido Hidrolasas , Receptores de Interleucina , Animales , Ratones , Caspasas , Catepsinas , Citocinas , Interleucina-1/metabolismo , Células Mieloides , Receptores de Interleucina/metabolismo
2.
Cytokine ; 157: 155935, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35759924

RESUMEN

Members of the extended IL-1 cytokine family play key roles as instigators of inflammation in numerous infectious and sterile injury contexts and are highly enriched at barrier surfaces such as the skin, lungs and intestinal mucosa. Because IL-1 family cytokines do not possess conventional ER-golgi trafficking and secretory signals, these cytokines are typically released into the extracellular space due to tissue damage resulting in necrosis, or pathogen detection resulting in pyroptosis. The latter feature, in combination with other factors, suggests that IL-1 family cytokines serve as canonical damage-associated molecular patterns (DAMPs), which instigate inflammation in response to tissue damage. However, IL-1 family cytokines also require a proteolytic activation step and diverse intracellular, extracellular and non-self proteases have been identified that are capable of processing and activating members of this family. This suggests that IL-1 family members function as sentinels for aberrant protease activity, which is frequently associated with infection or tissue damage. Here, we overview the diversity of proteases implicated in the activation of IL-1 family cytokines and suggest that this ancient cytokine family may have evolved to complement 'pattern recognition receptors', by serving as 'activity recognition receptors' enabling the detection of aberrant enzyme activity indicative of 'danger'.


Asunto(s)
Alarminas , Citocinas , Humanos , Inflamasomas , Inflamación , Interleucina-1 , Péptido Hidrolasas
3.
J Biol Chem ; 298(5): 101908, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-35398099

RESUMEN

Human Interleukin-18 (IL-18) is an omnipresent proinflammatory cytokine of the IL-1 family with central roles in autoimmune and inflammatory diseases and serves as a staple biomarker in the evaluation of inflammation in physiology and disease, including the inflammatory phase of COVID-19. The sequestration of IL-18 by its soluble decoy receptor IL-18-Binding Protein (IL-18BP) is critical to the regulation of IL-18 activity. Since an imbalance in expression and circulating levels of IL-18 is associated with disease, structural insights into how IL-18BP outcompetes binding of IL-18 by its cognate cell-surface receptors are highly desirable; however, the structure of human IL-18BP in complex with IL-18 has been elusive. Here, we elucidate the sequestration mechanism of human IL-18 mediated by IL-18BP based on the crystal structure of the IL-18:IL-18BP complex. These detailed structural snapshots reveal the interaction landscape leading to the ultra-high affinity of IL-18BP toward IL-18 and identify substantial differences with respect to previously characterized complexes of IL-18 with IL-18BP of viral origin. Furthermore, our structure captured a fortuitous higher-order assembly between IL-18 and IL-18BP coordinated by a disulfide-bond distal to the binding surface connecting IL-18 and IL-18BP molecules from different complexes, resulting in a novel tetramer with 2:2 stoichiometry. This tetrapartite assembly was found to restrain IL-18 activity more effectively than the canonical 1:1 complex. Collectively, our findings provide a framework for innovative, structure-driven therapeutic strategies and further functional interrogation of IL-18 in physiology and disease.


Asunto(s)
Péptidos y Proteínas de Señalización Intercelular , Interleucina-18/metabolismo , COVID-19/inmunología , Humanos , Inflamación , Neoplasias/inmunología
4.
Dev Cell ; 52(6): 714-730.e5, 2020 03 23.
Artículo en Inglés | MEDLINE | ID: mdl-32109381

RESUMEN

Inflammation triggered by infection or cellular necrosis is initiated by a battery of pattern-recognition receptors, such as Toll-like receptors or IL-1 family receptors. Diverse forms of cell stress, such as ER stress or mitochondrial stress, can also promote inflammatory responses that contribute to the chronic inflammation observed in cancer, obesity, and other conditions. However, the molecular mechanisms of cell-stress-induced inflammation are poorly understood. Here, we show that ER stress initiated NF-κB activation and inflammation through transcriptional upregulation and ligand-independent activation of TRAIL receptors. ER-stress-induced TRAIL receptor activation resulted in caspase-8/FADD/RIPK1-dependent NF-κB activation and inflammatory cytokine production. Silencing or deletion of TRAIL receptors, or their downstream effectors caspase-8, FADD, or RIPK1, suppressed ER-stress-induced inflammation. Furthermore, chemotherapeutic stress-induced inflammatory responses were blunted in DR5/TRAIL-R null animals. We propose that, upon ER stress, TRAIL receptors serve as "stress-associated molecular patterns (SAMPs)" coupling ER stress to NF-κB-dependent inflammation.


Asunto(s)
Citocinas/metabolismo , Estrés del Retículo Endoplásmico , Receptores del Ligando Inductor de Apoptosis Relacionado con TNF/metabolismo , Transducción de Señal , Células A549 , Animales , Caspasa 8/metabolismo , Células Cultivadas , Citocinas/genética , Proteína de Dominio de Muerte Asociada a Fas/metabolismo , Células HCT116 , Células HeLa , Humanos , Ratones , Ratones Endogámicos C57BL , FN-kappa B/metabolismo , Proteína Serina-Treonina Quinasas de Interacción con Receptores/metabolismo , Receptores del Ligando Inductor de Apoptosis Relacionado con TNF/genética
5.
Cell Death Differ ; 26(3): 395-408, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30622307

RESUMEN

Since the discovery and definition of neutrophil extracellular traps (NETs) 14 years ago, numerous characteristics and physiological functions of NETs have been uncovered. Nowadays, the field continues to expand and novel mechanisms that orchestrate formation of NETs, their previously unknown properties, and novel implications in disease continue to emerge. The abundance of available data has also led to some confusion in the NET research community due to contradictory results and divergent scientific concepts, such as pro- and anti-inflammatory roles in pathologic conditions, demarcation from other forms of cell death, or the origin of the DNA that forms the NET scaffold. Here, we present prevailing concepts and state of the science in NET-related research and elaborate on open questions and areas of dispute.


Asunto(s)
Trampas Extracelulares/metabolismo , Neutrófilos/metabolismo , Humanos
6.
Elife ; 72018 06 13.
Artículo en Inglés | MEDLINE | ID: mdl-29897333

RESUMEN

The apical inflammatory cytokine TNF regulates numerous important biological processes including inflammation and cell death, and drives inflammatory diseases. TNF secretion requires TACE (also called ADAM17), which cleaves TNF from its transmembrane tether. The trafficking of TACE to the cell surface, and stimulation of its proteolytic activity, depends on membrane proteins, called iRhoms. To delineate how the TNF/TACE/iRhom axis is regulated, we performed an immunoprecipitation/mass spectrometry screen to identify iRhom-binding proteins. This identified a novel protein, that we name iTAP (iRhom Tail-Associated Protein) that binds to iRhoms, enhancing the cell surface stability of iRhoms and TACE, preventing their degradation in lysosomes. Depleting iTAP in primary human macrophages profoundly impaired TNF production and tissues from iTAP KO mice exhibit a pronounced depletion in active TACE levels. Our work identifies iTAP as a physiological regulator of TNF signalling and a novel target for the control of inflammation.


Asunto(s)
Proteína ADAM17/metabolismo , Proteínas Portadoras/metabolismo , Proteínas del Citoesqueleto/metabolismo , Macrófagos/metabolismo , Proteínas de la Membrana/metabolismo , Factor de Necrosis Tumoral alfa/genética , Proteína ADAM17/genética , Secuencia de Aminoácidos , Animales , Proteínas Portadoras/genética , Línea Celular , Proteínas del Citoesqueleto/genética , Endosomas/metabolismo , Fibroblastos/citología , Fibroblastos/metabolismo , Regulación de la Expresión Génica , Células HEK293 , Células HeLa , Humanos , Péptidos y Proteínas de Señalización Intracelular , Macrófagos/citología , Proteínas de la Membrana/genética , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Cultivo Primario de Células , Unión Proteica , Proteolisis , Células RAW 264.7 , Alineación de Secuencia , Homología de Secuencia de Aminoácido , Transducción de Señal , Factor de Necrosis Tumoral alfa/metabolismo
7.
FEBS Open Bio ; 8(5): 751-763, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29744290

RESUMEN

IL-1 family cytokines act as apical initiators of inflammation in many settings and can promote the production of a battery of inflammatory cytokines, chemokines and other inflammatory mediators in diverse cell types. IL-36α, IL-36ß and IL-36γ, which belong to the extended IL-1 family, have been implicated as key initiators of skin inflammation in psoriasis. IL-36γ is highly upregulated in lesional skin from psoriatic individuals, and heritable mutations in the natural IL-36 receptor antagonist result in a severe form of psoriasis. IL-36 family cytokines are initially expressed as inactive precursors that require proteolytic processing for activation. The neutrophil granule-derived protease elastase proteolytically processes and activates IL-36α and IL-36γ, increasing their biological activity ~ 500-fold, and also robustly activates IL-1α and IL-33 through limited proteolytic processing. Consequently, inhibitors of elastase activity may have potential as anti-inflammatory agents through antagonizing the activation of multiple IL-1 family cytokines. Using in silico screening approaches, we have identified small-molecule inhibitors of elastase that can antagonize activation of IL-36γ by the latter protease. The compounds reported herein may have utility as lead compounds for the development of inhibitors of elastase-mediated activation of IL-36 and other IL-1 family cytokines in inflammatory conditions, such as psoriasis.

8.
Cell Rep ; 23(2): 470-484, 2018 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-29642005

RESUMEN

Tumor necrosis factor (TNF) is an inflammatory cytokine that can signal cell survival or cell death. The mechanisms that switch between these distinct outcomes remain poorly defined. Here, we show that the E3 ubiquitin ligase Mind Bomb-2 (MIB2) regulates TNF-induced cell death by inactivating RIPK1 via inhibitory ubiquitylation. Although depletion of MIB2 has little effect on NF-κB activation, it sensitizes cells to RIPK1- and caspase-8-dependent cell death. We find that MIB2 represses the cytotoxic potential of RIPK1 by ubiquitylating lysine residues in the C-terminal portion of RIPK1. Our data suggest that ubiquitin conjugation of RIPK1 interferes with RIPK1 oligomerization and RIPK1-FADD association. Disruption of MIB2-mediated ubiquitylation, either by mutation of MIB2's E3 activity or RIPK1's ubiquitin-acceptor lysines, sensitizes cells to RIPK1-mediated cell death. Together, our findings demonstrate that Mind Bomb E3 ubiquitin ligases can function as additional checkpoint of cytokine-induced cell death, selectively protecting cells from the cytotoxic effects of TNF.


Asunto(s)
Apoptosis , Proteína Serina-Treonina Quinasas de Interacción con Receptores/metabolismo , Factor de Necrosis Tumoral alfa/farmacología , Ubiquitina-Proteína Ligasas/metabolismo , Apoptosis/efectos de los fármacos , Caspasa 8/metabolismo , Línea Celular Tumoral , Células HEK293 , Humanos , Lipopolisacáridos/farmacología , FN-kappa B/metabolismo , Multimerización de Proteína/efectos de los fármacos , Interferencia de ARN , ARN Interferente Pequeño/metabolismo , Proteína Serina-Treonina Quinasas de Interacción con Receptores/antagonistas & inhibidores , Proteína Serina-Treonina Quinasas de Interacción con Receptores/genética , Transducción de Señal/efectos de los fármacos , Receptor Toll-Like 4/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Ubiquitina-Proteína Ligasas/antagonistas & inhibidores , Ubiquitina-Proteína Ligasas/genética , Ubiquitinación/efectos de los fármacos
9.
Cell Rep ; 22(11): 2937-2950, 2018 03 13.
Artículo en Inglés | MEDLINE | ID: mdl-29539422

RESUMEN

Neutrophil granule proteases are thought to function as anti-microbial effectors, cooperatively hydrolyzing microorganisms within phagosomes, or upon deployment into the extracellular space. However, evidence also suggests that neutrophil proteases play an important role in the coordination and escalation of inflammatory reactions, but how this is achieved has been obscure. IL-1 family cytokines are important initiators of inflammation and are typically released via necrosis but require proteolytic processing for activation. Here, we show that proteases liberated from activated neutrophils can positively or negatively regulate the activity of six IL-1 family cytokines (IL-1α, IL-1ß, IL-33, IL-36α, IL-36ß, and IL-36γ) with exquisite sensitivity. In contrast, extracellular neutrophil proteases displayed very poor bactericidal activity, exhibiting 100-fold greater potency toward cytokine processing than bacterial killing. Thus, in addition to their classical role as phagocytes, neutrophils play an important immunoregulatory role through deployment of their granule proteases into the extracellular space to process multiple IL-1 family cytokines.


Asunto(s)
Citocinas/metabolismo , Espacio Extracelular/metabolismo , Interleucina-1/metabolismo , Interleucina-1alfa/metabolismo , Interleucina-33/metabolismo , Neutrófilos/metabolismo , Péptido Hidrolasas/metabolismo , Humanos
10.
Cell Death Dis ; 9(3): 378, 2018 03 07.
Artículo en Inglés | MEDLINE | ID: mdl-29515113

RESUMEN

Sterile inflammation is initiated by molecules released from necrotic cells, called damage-associated molecular patterns (DAMPs). Members of the extended IL-1 cytokine family are important DAMPs, are typically only released through necrosis, and require limited proteolytic processing for activation. The IL-1 family cytokines, IL-36α, IL-36ß, and IL-36γ, are expressed as inactive precursors and have been implicated as key initiators of psoriatic-type skin inflammation. We have recently found that IL-36 family cytokines are proteolytically processed and activated by the neutrophil granule-derived proteases, elastase, and cathepsin G. Inhibitors of IL-36 processing may therefore have utility as anti-inflammatory agents through suppressing activation of the latter cytokines. We have identified peptide-based pseudosubstrates for cathepsin G and elastase, based on optimal substrate cleavage motifs, which can antagonize activation of all three IL-36 family cytokines by the latter proteases. Human psoriatic skin plaques displayed elevated IL-36ß processing activity that could be antagonized by peptide pseudosubstrates specific for cathepsin G. Thus, antagonists of neutrophil-derived proteases may have therapeutic potential for blocking activation of IL-36 family cytokines in inflammatory conditions such as psoriasis.


Asunto(s)
Inflamación/metabolismo , Interleucina-1/metabolismo , Neutrófilos/enzimología , Péptido Hidrolasas/metabolismo , Antiinflamatorios/uso terapéutico , Catepsina G/metabolismo , Células HeLa , Humanos , Neutrófilos/efectos de los fármacos , Elastasa Pancreática/metabolismo , Psoriasis/tratamiento farmacológico , Psoriasis/metabolismo , Piel/efectos de los fármacos , Piel/metabolismo , Piel/patología
11.
FEBS J ; 284(11): 1712-1725, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-28374518

RESUMEN

Activated neutrophils can undergo a mode of regulated cell death, called NETosis, that results in the extrusion of chromatin into the extracellular space, thereby acting as extracellular traps for microorganisms. Neutrophil-derived extracellular traps (NETs) are comprised of DNA decorated with histones, antimicrobial proteins and neutrophil granule proteases, such as elastase and cathepsin G (Cat G). NET-associated factors are thought to enhance the antimicrobial properties of these structures and localisation of antimicrobial molecules on NETs may serve to increase their local concentration. Because neutrophil-derived proteases have been implicated in the processing and activation of several members of the extended interleukin (IL)-1 family, we wondered whether neutrophil NETs could also serve as platforms for the activation of proinflammatory cytokines. Here, we show that neutrophil NETs potently processed and activated IL-1α as well as IL-36 subfamily cytokines through NET-associated Cat G and elastase. Thus, in addition to their role as antimicrobial traps, NETs can also act as local sites of cytokine processing and activation.


Asunto(s)
Catepsina G/metabolismo , Trampas Extracelulares/fisiología , Interleucina-1/metabolismo , Interleucina-1alfa/metabolismo , Elastasa de Leucocito/metabolismo , Mieloblastina/metabolismo , Activación Neutrófila , Gránulos Citoplasmáticos/enzimología , Desoxirribonucleasa I/farmacología , Trampas Extracelulares/enzimología , Humanos , Inflamación/sangre , Activación Neutrófila/efectos de los fármacos , Proteínas Recombinantes/metabolismo , Acetato de Tetradecanoilforbol/farmacología
12.
Cell Host Microbe ; 20(5): 552-554, 2016 11 09.
Artículo en Inglés | MEDLINE | ID: mdl-27832584

RESUMEN

Influenza A initiates host cell death through unknown mechanisms. Thapa et al. (2016) in this issue of Cell Host & Microbe, along with recent work by Kuriakose et al. (2016), indicate that this virus provokes divergent modes of cell death, including apoptosis and necroptosis, via the nucleic acid sensor, DAI.


Asunto(s)
Muerte Celular , Virus de la Influenza A , Necrosis , Apoptosis
13.
FEBS Open Bio ; 6(4): 338-48, 2016 04.
Artículo en Inglés | MEDLINE | ID: mdl-27239446

RESUMEN

Recent evidence has strongly implicated IL-36 cytokines as key initiators of inflammation in the skin barrier. IL-36 cytokines belong to the extended IL-1 family and, similar to most members of this family, are expressed as inactive precursors that require proteolytic processing for activation. Because the proteases responsible for activation of members of the IL-36 subfamily have not been reported, we have developed a method for the production of biologically active IL-36 through introduction of a caspase cleavage motif, DEVD, within the N-termini of these cytokines. Here, we show that DEVD-modified IL-36α, IL-36ß and IL-36γ cytokines were highly soluble and were readily processed and activated by caspase-3. Caspase-3-processed IL-36 family cytokines exhibited robust biological activity on a range of responsive cell types, including primary keratinocytes. We also generated specific polyclonal antibodies against all three IL-36 family members through immunization with purified recombinant IL-36 cytokines. The modified forms of IL-36 described herein will be useful for production of large quantities of biologically active IL-36 for structure and function studies on these important proinflammatory cytokines.

14.
Cell Rep ; 14(4): 708-722, 2016 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-26776523

RESUMEN

Recent evidence has strongly implicated the IL-1 family cytokines IL-36α, IL-36ß, and IL-36γ as key initiators of skin inflammation. Similar to the other members of the IL-1 family, IL-36 cytokines are expressed as inactive precursors and require proteolytic processing for activation; however, the responsible proteases are unknown. Here, we show that IL-36α, IL-36ß, and IL-36γ are activated differentially by the neutrophil granule-derived proteases cathepsin G, elastase, and proteinase-3, increasing their biological activity ~500-fold. Active IL-36 promoted a strong pro-inflammatory signature in primary keratinocytes and was sufficient to perturb skin differentiation in a reconstituted 3D human skin model, producing features resembling psoriasis. Furthermore, skin eluates from psoriasis patients displayed significantly elevated cathepsin G-like activity that was sufficient to activate IL-36ß. These data identify neutrophil granule proteases as potent IL-36-activating enzymes, adding to our understanding of how neutrophils escalate inflammatory reactions. Inhibition of neutrophil-derived proteases may therefore have therapeutic benefits in psoriasis.


Asunto(s)
Catepsinas/metabolismo , Interleucina-1/metabolismo , Neutrófilos/inmunología , Psoriasis/inmunología , Células Cultivadas , Células HeLa , Humanos , Queratinocitos/metabolismo , Activación Neutrófila , Neutrófilos/enzimología
15.
Cell Rep ; 11(10): 1535-48, 2015 Jun 16.
Artículo en Inglés | MEDLINE | ID: mdl-26027935

RESUMEN

The NLRP3 inflammasome is involved in caspase-1-dependent maturation of IL-1ß in many contexts. A two-signal model has emerged for IL-1ß maturation, with LPS providing "signal I" and diverse agents such as ATP, Nigericin, streptolysin O, uric acid crystals, and alum salts capable of acting as "signal II." In the absence of signal II, pro-IL-1ß is upregulated but typically fails to be processed or released. What unites signal II stimuli has been debated, with the ability to promote K+ efflux suggested as a common factor, but the mechanism of IL-1ß release remains unclear. Here, we show that all examined inflammasome signal II agents triggered necrosis, which was highly correlated with their ability to promote IL-1ß release. IL-1ß secretion occurred in tandem with the release of many additional proteins and was confined to necrotic cells. Thus, signal II agents initiate inflammation by promoting necrosis-driven IL-1ß release, suggesting that IL-1ß represents an inducible danger signal.


Asunto(s)
Proteínas Portadoras/metabolismo , Inflamasomas/metabolismo , Interleucina-1beta/metabolismo , Animales , Células HeLa , Humanos , Lipopolisacáridos/farmacología , Macrófagos/efectos de los fármacos , Macrófagos/metabolismo , Macrófagos/patología , Ratones , Monocitos/efectos de los fármacos , Monocitos/metabolismo , Monocitos/patología , Proteína con Dominio Pirina 3 de la Familia NLR , Necrosis/metabolismo , Transducción de Señal , Regulación hacia Arriba/efectos de los fármacos
16.
FEBS J ; 281(21): 4921-34, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25195660

RESUMEN

Tumour necrosis factor and lipopolysaccharide can promote a regulated form of necrosis, called necroptosis, upon inhibition of caspase activity in cells expressing receptor-interacting serine/threonine kinase (RIPK)3. Because inhibitors of RIPK1 kinase activity such as necrostatin-1 block necroptosis in many settings, RIPK1 is thought to be required for activation of RIPK3, leading to necroptosis. However, here we show that, although necrostatin potently inhibited tumour necrosis factor-induced, lipopolysaccharide-induced and polyIC-induced necroptosis, RIPK1 knockdown unexpectedly potentiated this process. In contrast, RIPK3 knockdown potently suppressed necroptosis under the same conditions. Significantly, necrostatin failed to block necroptosis in the absence of RIPK1, indicating that its ability to suppress necroptosis was indeed RIPK1-dependent. These data argue that RIPK1 is dispensable for necroptosis and can act as an inhibitor of this process. Our observations also suggest that necrostatin enhances the inhibitory effects of RIPK1 on necroptosis, as opposed to blocking its participation in this process.


Asunto(s)
Apoptosis/efectos de los fármacos , Imidazoles/farmacología , Indoles/farmacología , Proteína Serina-Treonina Quinasas de Interacción con Receptores/fisiología , Clorometilcetonas de Aminoácidos/farmacología , Animales , Apoptosis/fisiología , Inhibidores de Caspasas/farmacología , Células Cultivadas , Fibroblastos , Células L , Lipopolisacáridos/farmacología , Macrófagos , Ratones , Fosforilación , Poli I-C/farmacología , Procesamiento Proteico-Postraduccional , Interferencia de ARN , ARN Interferente Pequeño/farmacología , Proteína Serina-Treonina Quinasas de Interacción con Receptores/antagonistas & inhibidores , Proteína Serina-Treonina Quinasas de Interacción con Receptores/genética , Factor de Necrosis Tumoral alfa/farmacología
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