TNF and rheumatoid arthritis: ETN can affect the production of various cytokines, chemokines, and proteases, possibly downstream of a pot of TNF-α cascade and regulating inflammatory processes in RA.[44] Lina et al[42] found that the combination of ETN and MTX can ameliorate the activity of the disease by regulating the differentiation or function of Th17 and Treg, and the patients treated with MTX alone showed no significant reversal of Th1/Th2 or Th17/Treg imbalances and no satisfactory remission after 12 weeks of treatment.