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.