TNF-alpha→Insulin→Pravastatin→c-jun

• 20120429(TNF-alpha): Recalcitrant cicatricial pemphigoid treated with the anti-TNF-alpha agent etanercept.

  This report will discuss the possible mechanism of action of the addition of TNF-alpha inhibitors as a steroid-sparing agent in these patients.

• 17726611(Insulin): Effect of etanercept on insulin secretion and insulin sensitivity in a randomized trial with psoriatic patients at risk for developing type 2 diabetes mellitus.

  The purpose of this study was to determine the effect of etanercept , a TNF-alpha inhibitor , on insulin secretion and insulin sensitivity in psoriatic patients with high risk factors to develop type 2 diabetes mellitus.

• 16171951(Pravastatin): Protective role of pravastatin in the pathogenesis of the metabolic syndrome.

  It may improve the insulin sensitivity in these patients and subsequently prevent the development of type 2 diabetes.

• 20231445(c-jun): Hypothalamic and pituitary c-Jun N-terminal kinase 1 signaling coordinately regulates glucose metabolism.

  c-Jun N-terminal kinase (JNK) 1-dependent signaling plays a crucial role in the development of obesity-associated insulin resistance.