# Selective Inhibition of Tumor Necrosis Factor for Attenuating Alzheimer’s Disease: Strategies Targeting Neuroinflammation

**Authors:** Janakiraman Pillai Udaiyappan, Rengasamy Balakrishnan, Manivasagam Muthukumaran Tamilarasan, Balamuralikrishnan Balasubramanian, Kasim Sakran Abass

PMC · DOI: 10.1007/s10753-026-02492-9 · 2026-03-14

## TL;DR

This review explores how selectively blocking TNF-α, a key inflammatory molecule, could help treat Alzheimer’s disease by reducing harmful brain inflammation.

## Contribution

The paper introduces targeted TNF-α inhibition as a novel therapeutic strategy for Alzheimer’s disease.

## Key findings

- TNF-α activation worsens amyloid and tau pathology in Alzheimer’s disease.
- Selective TNF-α inhibitors show promise in preclinical and clinical studies for regulating neuroinflammation.
- Combining TNF-α inhibition with other approaches may offer a more effective treatment for Alzheimer’s.

## Abstract

Neuroinflammation is increasingly recognized as a key feature in the development of Alzheimer’s disease (AD), with tumor necrosis factor-alpha (TNF-α) playing a crucial role in initiating inflammatory responses. Continuous activation of TNF-α leads to synaptic dysfunction, neuronal loss, and worsening of amyloid and tau pathology. Specifically, the upregulation of the pro-inflammatory cytokine TNF-α in the brain activates its receptors (TNFR1 & TNFR2). Targeting TNF-α through selective inhibition presents a promising therapeutic strategy for regulating neuroinflammatory responses without compromising systemic immunity. This review discusses current insights into TNF-α signaling in AD progression and examines the effectiveness of selective TNF-α inhibitors in preclinical and clinical studies. We also highlighted specific TNF-α inhibitors, including small molecules and gene therapy approaches, for chronic inflammatory conditions and discussed the limitations and future directions of the current review. Targeted TNF-α inhibition could serve as a novel, disease-modifying treatment for AD, especially when combined with multi-targeted approaches addressing amyloid burden, tau pathology, oxidative stress, and neuroinflammation.

## Linked entities

- **Proteins:** TNF (tumor necrosis factor), TNFRSF1A (TNF receptor superfamily member 1A), TNFRSF1B (TNF receptor superfamily member 1B)
- **Diseases:** Alzheimer’s disease (MONDO:0004975)

## Full-text entities

- **Genes:** Bdnf (brain derived neurotrophic factor) [NCBI Gene 12064], MTOR (mechanistic target of rapamycin kinase) [NCBI Gene 2475] {aka FRAP, FRAP1, FRAP2, RAFT1, RAPT1, SKS}, TYROBP (transmembrane immune signaling adaptor TYROBP) [NCBI Gene 7305] {aka DAP12, KARAP, PLOSL, PLOSL1}, Pdk1 (pyruvate dehydrogenase kinase, isoenzyme 1) [NCBI Gene 228026] {aka B830012B01, D530020C15Rik}, CXCL8 (C-X-C motif chemokine ligand 8) [NCBI Gene 3576] {aka GCP-1, GCP1, IL8, LECT, LUCT, LYNAP}, Tnfsf11 (TNF superfamily member 11) [NCBI Gene 117516] {aka ODF, OPGL, RANKL, TRANCE}, GFAP (glial fibrillary acidic protein) [NCBI Gene 2670] {aka ALXDRD}, APOE (apolipoprotein E) [NCBI Gene 348] {aka AD2, APO-E, ApoE4, LDLCQ5, LPG}, TRAF2 (TNF receptor associated factor 2) [NCBI Gene 7186] {aka MGC:45012, RNF117, TRAP, TRAP3}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, MMP1 (matrix metallopeptidase 1) [NCBI Gene 4312] {aka CLG}, MAPT (microtubule associated protein tau) [NCBI Gene 4137] {aka DDPAC, FTD1, FTDP-17, MAPTL, MSTD, MTBT1}, Il6 (interleukin 6) [NCBI Gene 16193] {aka Il-6}, Psen1 (presenilin 1) [NCBI Gene 19164] {aka Ad3h, PS-1, PS1, S182}, Akt1 (Akt serine/threonine kinase 1) [NCBI Gene 11651] {aka Akt, LTR-akt, PKB, PKB/Akt, PKBalpha, Rac}, Fadd (Fas associated via death domain) [NCBI Gene 14082] {aka Mort1/FADD}, PIK3R1 (phosphoinositide-3-kinase regulatory subunit 1) [NCBI Gene 5295] {aka AGM7, GRB1, IMD36, p85, p85-ALPHA, p85alpha}, MLKL (mixed lineage kinase domain like pseudokinase) [NCBI Gene 197259] {aka hMLKL}, Mapk8 (mitogen-activated protein kinase 8) [NCBI Gene 26419] {aka JNK, JNK1, Prkm8, SAPK1}, APP (amyloid beta precursor protein) [NCBI Gene 351] {aka AAA, ABETA, ABPP, AD1, APPI, CTFgamma}, RIPK3 (receptor interacting serine/threonine kinase 3) [NCBI Gene 11035] {aka RIP3}, Ripk3 (receptor-interacting serine-threonine kinase 3) [NCBI Gene 56532] {aka 2610528K09Rik, Rip3}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, Casp8 (caspase 8) [NCBI Gene 12370] {aka CASP-8, FLICE, MACH, Mch5}, Xpnpep3 (X-prolyl aminopeptidase 3, mitochondrial) [NCBI Gene 321003] {aka APP3, E430012M05Rik}, BIRC3 (baculoviral IAP repeat containing 3) [NCBI Gene 330] {aka AIP1, API2, CIAP2, HAIP1, HIAP1, IAP-1}, MMP3 (matrix metallopeptidase 3) [NCBI Gene 4314] {aka CHDS6, MMP-3, SL-1, STMY, STMY1, STR1}, IL10 (interleukin 10) [NCBI Gene 3586] {aka CSIF, GVHDS, IL-10, IL10A, TGIF}, Tnf (tumor necrosis factor) [NCBI Gene 24835] {aka RATTNF, TNF-alpha, Tnfa}, BIRC2 (baculoviral IAP repeat containing 2) [NCBI Gene 329] {aka API1, HIAP2, Hiap-2, IAP-2, MIHB, RNF48}, Ripk1 (receptor (TNFRSF)-interacting serine-threonine kinase 1) [NCBI Gene 19766] {aka D330015H01Rik, RIP, RIP-1, Rinp, Rip1}, Dlg4 (discs large MAGUK scaffold protein 4) [NCBI Gene 13385] {aka Dlgh4, PSD-95, PSD95, SAP90, SAP90A}, LTA (lymphotoxin alpha) [NCBI Gene 4049] {aka LT, TNFB, TNFSF1, TNLG1E}, Mtor (mechanistic target of rapamycin kinase) [NCBI Gene 56717] {aka 2610315D21Rik, FRAP, FRAP2, Frap1, RAFT1, RAPT1}, ECSCR (endothelial cell surface expressed chemotaxis and apoptosis regulator) [NCBI Gene 641700] {aka ARIA, ECSM2}, Tnfrsf1a (TNF receptor superfamily member 1A) [NCBI Gene 25625] {aka TNFR-1, Tnfr1}, BACE1 (beta-secretase 1) [NCBI Gene 23621] {aka ASP2, BACE, HSPC104}, Tnfrsf1a (tumor necrosis factor receptor superfamily, member 1a) [NCBI Gene 21937] {aka CD120a, FPF, TNF-R, TNF-R-I, TNF-R1, TNF-R55}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, C1QA (complement C1q A chain) [NCBI Gene 712] {aka C1QD1}, Cd40 (CD40 antigen) [NCBI Gene 21939] {aka Bp50, GP39, HIGM1, IGM, IMD3, T-BAM}, FAS (Fas cell surface death receptor) [NCBI Gene 355] {aka ALPS1A, APO-1, APT1, CD95, FAS1, FASTM}, RNF31 (ring finger protein 31) [NCBI Gene 55072] {aka HOIP, IMD115, Paul, ZIBRA}, C3 (complement C3) [NCBI Gene 718] {aka AHUS5, ARMD9, ASP, C3a, C3b, CPAMD1}, RELB (RELB proto-oncogene, NF-kB subunit) [NCBI Gene 5971] {aka I-REL, IMD53, IREL, REL-B}, NFKB2 (nuclear factor kappa B subunit 2) [NCBI Gene 4791] {aka CVID10, H2TF1, LYT-10, LYT10, NF-kB2, p100}, Tnfrsf1b (tumor necrosis factor receptor superfamily, member 1b) [NCBI Gene 21938] {aka CD120b, TNF-R-II, TNF-R2, TNF-R75, TNF-alphaR2, TNFBR}, IL18 (interleukin 18) [NCBI Gene 3606] {aka IGIF, IL-18, IL-1g, IL1F4}, RIPK1 (receptor interacting serine/threonine kinase 1) [NCBI Gene 8737] {aka AIEFL, IMD57, RIP, RIP-1, RIP1}, TRADD (TNFRSF1A associated via death domain) [NCBI Gene 8717] {aka Hs.89862}, TREM2 (triggering receptor expressed on myeloid cells 2) [NCBI Gene 54209] {aka AD17, PLOSL2, TREM-2, Trem2a, Trem2b, Trem2c}, Tnf (tumor necrosis factor) [NCBI Gene 21926] {aka DIF, TNF-a, TNF-alpha, TNFSF2, TNFalpha, Tnfa}, SELE (selectin E) [NCBI Gene 6401] {aka CD62E, ELAM, ELAM1, ESEL, LECAM2, selectin-e}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, MAP3K14 (mitogen-activated protein kinase kinase kinase 14) [NCBI Gene 9020] {aka FTDCR1B, HS, HSNIK, IMD112, NIK}, SQSTM1 (sequestosome 1) [NCBI Gene 8878] {aka A170, DMRV, EBIAP, FTDALS3, NADGP, OSIL}, Cd40lg (CD40 ligand) [NCBI Gene 21947] {aka CD154, CD40-L, Cd40l, HIGM1, IGM, IMD3}, ICAM1 (intercellular adhesion molecule 1) [NCBI Gene 3383] {aka BB2, CD54, P3.58}, ADAM17 (ADAM metallopeptidase domain 17) [NCBI Gene 6868] {aka ADAM18, CD156B, CSVP, HYPT16, NISBD, NISBD1}, ERVK-13 (endogenous retrovirus group K member 13) [NCBI Gene 100861467] {aka c3_D}
- **Diseases:** cartilage and bone loss (MESH:D002357), ischemic (MESH:D002545), autoimmune and inflammatory disease (MESH:D001327), dementia (MESH:D003704), Onchocerca volvulus infection (MESH:D045822), neurol loss (MESH:D016388), disorientation (MESH:D003221), onchocerciasis (MESH:D009855), Chronic Inflammatory Conditions (MESH:D002908), TNF toxicity (MESH:D009369), acute liver injury (MESH:D017114), Parkinsonism (MESH:D010302), gliosis (MESH:D005911), Crohn's disease (MESH:D003424), ulcerative colitis (MESH:D003093), tissue injury (MESH:D017695), PMG (MESH:C538319), multiple sclerosis (MESH:D009103), reactive (MESH:D000275), cerebral edema (MESH:D001929), neuronal dysfunction (MESH:D009461), Amyloid (MESH:C000718787), heart failure (MESH:D006333), AD (MESH:D000544), necrosis (MESH:D009336), Vascular dementia (MESH:D015140), dopaminergic neuron degeneration (MESH:D009410), memory impairment (MESH:D008569), motor dysfunction (MESH:D000068079), amyotrophic lateral sclerosis (MESH:D000690), -mediated cytotoxicity (MESH:C567355), amnesia (MESH:D000647), acute and chronic inflammation (MESH:D007249), language impairment (MESH:D007806), synaptic loss (MESH:D012183), fatalities (MESH:C565541), retinal ischemia (MESH:D012173), infection (MESH:D007239), trauma (MESH:D014947), juvenile idiopathic arthritis (MESH:D001171), effusion (MESH:D000080324), river blindness (MESH:D015827), brain injury (MESH:D001930), experimental autoimmune encephalomyelitis (MESH:D004681), depression (MESH:D003866), trypanosomiasis (MESH:D014352), deficits in learning and memory (MESH:D007859), amyloid-related imaging abnormalities (MESH:C564543), ankylosing spondylitis (MESH:D013167), synaptic dysfunction (MESH:C536122), cytotoxic (MESH:D064420), Behcet's disease (MESH:D001528), Neuroinflammation (MESH:D000090862), arthritis (MESH:D001168), Parkinson's disease (MESH:D010300), mood and behavioral disturbances (MESH:D019964), cognitive and motor deficits (MESH:D003072), Neurotoxic (MESH:D020258), psoriatic arthritis (MESH:D015535), neuropathy (MESH:D009422)
- **Chemicals:** ROS (MESH:D017382), glutamate (MESH:D018698), lecanemab (MESH:C000612089), MTX (MESH:D008727), PI (MESH:D010716), PEG (MESH:D011092), aducanumab (MESH:C000600266), Evans blue (MESH:D005070), prostaglandin E2 (MESH:D015232), LPS (MESH:D008070), tm (MESH:D013932), trypan blue (MESH:D014343), Adalimumab (MESH:D000068879), SPD304 (MESH:C527814), glucose (MESH:D005947), Inflectra (MESH:D000069285), prostanoids (MESH:D011453), nitric oxide (MESH:D009569), GABA (MESH:D005680), PIP2 (MESH:D019269), Suramin (MESH:D013498), FFDA (-), malondialdehyde (MESH:D008315), Certolizumab (MESH:D000068582), disulfide (MESH:D004220), doxorubicin (MESH:D004317), lipid (MESH:D008055), Golimumab (MESH:C529000)
- **Species:** Rheum officinale (yao yong da huang, species) [taxon 137220], Rattus norvegicus (brown rat, species) [taxon 10116], Rodentia (rodent, order) [taxon 9989], Mus musculus (house mouse, species) [taxon 10090], Homo sapiens (human, species) [taxon 9606], Macaca mulatta (rhesus macaque, species) [taxon 9544]
- **Mutations:** -308 A/G
- **Cell lines:** L929 — Mus musculus (Mouse), Spontaneously immortalized cell line (CVCL_AR58)

## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC13031254/full.md

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Source: https://tomesphere.com/paper/PMC13031254