Risk of Tumor Necrosis Factor Alpha Inhibitors Usage and Related Adverse Effects

Tumor necrosis factor (TNF) plays a role in host cell defense. TNF-alpha (TNF-α), secreted from macrophage has an important role in proinflammatory response mechanism. TNF-α levels increase in autoimmune, systemic inflammatory diseases, especially rheumatological diseases. Therefore, TNF-α inhibitors are alternant in the treatment of many inflammatory diseases. TNF-α inhibitors are not the first choice of clinicians due to their important adverse effects, despite the fact that successful results in diseases treatments. Treatment with TNF-α inhibitors causes different adverse effects including many bacterial, viral and fungal infectious diseases, lung diseases, demyelinating diseases, and malignancies. One of the most important adverse effect is tuberculosis (TB) by Mycobacterium tuberculosis bacillus. TB occurs through reactivation in Latent TB infection. Thus, TB screening tests appliedbefore TNF-α inhibitors treatment have an importance. In this review, TNF-α inhibitors and their important adverse effect TB flaming were discussed, and also genetic background features of these molecules have been explained.