TNF and rheumatoid arthritis: In rheumatoid arthritis, adalimumab acts primarily by neutralizing soluble TNF-α, while in inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis, binding to the membrane-bound form of TNF-α can trigger a range of biological effects such as alteration in levels of adhesion molecules, suppression of cytokine secretion and induction of apoptosis through reverse signaling.