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It is likely that the induction of tmTNF- mediated reverse signaling by itself does not explain all adverse events with anti-TNF- agents, but manipulation of this characteristic of anti-TNF therapies provides a route to rationally design safer and more broadly effective anti-TNF- agents with minimal or abrogated tmTNF- interaction

Okuda, T., Matsuda, Y., Yamanaka, A

The effect is much more on those who engage in regular workouts compared to those with a sedentary lifestyle