Biosimilars in Inflammatory Bowel Disease: Facts and Fears of Extrapolation  Shomron Ben-Horin, Niels Vande Casteele, Stefan Schreiber, Peter Laszlo Lakatos  Clinical Gastroenterology and Hepatology  Volume 14, Issue 12, Pages 1685-1696 (December 2016) DOI: 10.1016/j.cgh.2016.05.023 Copyright © 2016 AGA Institute Terms and Conditions

Figure 1 Established and possible mechanisms of action of infliximab and some other anti-TNF monoclonal antibodies in IBD. Binding to tmTNF and sTNF neutralizes the biological effects of TNF, preventing amplification of inflammation that can occur in IBD. Binding to tmTNF also causes reverse signaling and induction of apoptosis and regulatory M2 macrophages, which are thought to possibly play a role in the control of IBD. ADCC and CDC have been suggested but not shown to be a mechanism of action of anti-TNF antibodies. CDC, complement-dependent cytotoxicity; MOA, mechanism of action; NK, natural killer. Clinical Gastroenterology and Hepatology 2016 14, 1685-1696DOI: (10.1016/j.cgh.2016.05.023) Copyright © 2016 AGA Institute Terms and Conditions