Fig. 5. Etanercept inhibits tumor necrosis factor (TNF) action on mesothelial cells and neutrophils. (A, B) Human mesothelial cell line, MeT5A cells (A) or primary human neutrophils (B) were exposed to 10 ng/mL TNF for 21 h with or without 3 h-etanercept pretreatment. Cells were harvested for quantification of mRNA levels of IL-6 (A, B), CXCL-2 (A, B), PAI-1 (A), and TNF (B). Data are presented as mean ± SEM. *p<0.05 indicated statistically significant differences. (C) Proposed model for the role of TNF in the induction of postoperative adhesion: upon abdominal surgery, the injured serosa is exposed to TNF in the early phase. TNF triggers various adhesion formation-related events such as IL-6 and CXCL-2 induction and neutrophil extracellular trap (NET) formation. Prophylactic administration of etanercept might prevent postoperative adhesion formation by inhibiting these events.