Figure 1 Structure of TNF antagonists

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Figure 1 Structure of TNF antagonists Figure 1 | Structure of TNF antagonists. a | Schematic representation of an antibody molecule. The Fc region is responsible for the effector functions of the antibody, and the Fab region forms the antigen-binding site. Within the variable regions are small areas of hypervariability, which determine antigen specificity. b | Anti-TNF antibody constructs used in the treatment of rheumatoid arthritis. Infliximab is a chimeric monoclonal antibody with a murine variable region (shown in red) fused to a human Fcγ1 Ig. Adalimumab and golimumab are fully human monoclonal antibodies. Certolizumab is a humanized Fab' fragment bound to polyethylene glycol (PEG) molecules. Etanercept is a TNF receptor–Fcγ1 fusion protein. Potentially immunogenic areas within each antibody construct are indicated in red. Abbreviations: CH, constant heavy; CL, constant light; TNFR2, TNF receptor 2; VH, variable heavy; VL, variable light. Kalden, J. R. & Schulze-Koops, H. (2017) Immunogenicity and loss of response to TNF inhibitors: implications for rheumatoid arthritis treatment Nat. Rev. Rheumatol. doi:10.1038/nrrheum.2017.187