Tumor necrosis factor assay. Properties and mechanisms of TNF

TNF-aandTNF-b- two close proteins (about 30% of amino acid residues are homologous) - they show similar activity in relation to the inflammatory response, immune and tumor processes. TNF-α, first detected in the serum of mice injected with bacterial products, induces tumor cell necrosis. TNF-b, or lymphotoxin, has been found in the lymph nodes of immunized rats. The source of TNF-a is activated macrophage,TNF-b - activatedT cell. Both factors through the same specificTNF receptors cell surface cause lysis of lymphoma cells, sarcoma necrosis induced by methylcholanthrene, activate polymorphonuclear leukocytes, exhibit antiviral activity.

TNF-alpha (also called cachectin) ispyrogen. Plays an important role in pathogenesis septic shock caused by gram-negative bacteria. Under the influence of TNF-alpha, the formation of macrophages and neutrophils sharply increases hydrogen peroxideand others free radicals. In chronic inflammation, TNF-alpha activates catabolic processes and thereby contributes to the development cachexiais a symptom of many chronic diseases.

When studying the various products secreted by activatedmacrophages, a factor was obtained that lysed a large set oftumor cellsin vivo and in vitro. According to the main biological effect, it received the name - tumor necrosis factor.

In parallel studies from cultures of activatedT cells isolated another factor that also had lytic activity against foreign cells. Based on the type of cells that produce this factor, it has come to be referred to as lymphotoxin. A detailed study of these factors revealed a close structural and functional similarity between them. Their real name is tumor necrosis factor-alpha (TNF-alpha)andtumor necrosis factor-beta (TNF-beta, lymphotoxin).

5. Colony stimulating factors

Colony stimulating factors - hormones that stimulate the formation ofmonocytesand neutrophilsinbone marrow.

In the study of the culture of hematopoietic cells, it was shown that specific cells are needed for reproduction and differentiation of cells. growth factors. Supporting factorshematopoiesisin such a culture,glycoproteins and are commonly referred to as colony stimulating factors, or CSFs. Of the increasing number of CSFs that have been identified, some circulate in the blood and act as hormones, while others play the role of localchemical mediators.

Thesecytokines(colony-stimulating factors) are involved in the regulation of division and differentiation of stem cells bone marrow and cells - precursors of blood leukocytes. The balance of various CSFs to a certain extent determines the ratio between the various types of leukocytes formed in the bone marrow. Some CSF stimulate further cell differentiation outside the bone marrow.

Of the hormonal type CSF, the best studiederythropoietinwhich is produced in the kidneysand governserythropoiesis(educationerythrocytes).

For the survival and proliferation of pluripotent stem cells and most types of their committed descendants of the erythroid series, the second colony-stimulating factor is responsible - interleukin 3(IL-3). Four different CSFs were also identified that stimulate the formation of colonies in cell cultureneutrophilsandmacrophages. These CSFs are synthesized by various types of cells, includingendothelial cells, fibroblasts, macrophagesandlymphocytes. This is the above-mentioned interleukin 3 and more selectiveGM-CSF(forgranulocytesandmacrophages),G-CSF(for granulocytes) andM-CSF(for macrophages). Like erythropoietin, all of these CSFs are glycoproteins. Their effect on progenitor cells is not only to trigger the mechanism for the formation of differentiated colonies, but also to activate specialized functions (such as phagocytosisand killing of target cells) in cells with complete differentiation.

Mechanisms of action of cytokines

There are intracrine, autocrine, paracrine and endocrine mechanisms of action of cytokines. 1. Intracrine mechanism - the action of cytokines inside the producer cell; binding of cytokines to specific intracellular receptors. 2. Autocrine mechanism - the action of a secreted cytokine on the secreting cell itself. For example, interleukins-1, -6-18, TNFα are autocrine activating factors for monocytes/macrophages. 3. Paracrine mechanism - the action of cytokines on nearby cells and tissues. For example, IL-1, -6 -12 and -18, TNFα produced by a macrophage activate T-helper (Th0), which recognizes the antigen and MHC of the macrophage (Scheme of autocrine-paracrine regulation of the immune response). 4. Endocrine mechanism - the action of cytokines at a distance from the producing cells. For example, IL-1, -6 and TNFα, in addition to auto- and paracrine effects, can have a distant immunoregulatory effect, a pyrogenic effect, induction of the production of acute phase proteins by hepatocytes, symptoms of intoxication, and multiorgan lesions in toxic-septic conditions.

Violation mechanism

Many serious diseases lead to a significant increase in the levelIL-1andTNF-alpha. These cytokines promote the activation of phagocytes, their migration to the site of inflammation, as well as the releaseinflammatory mediators- derivatives of lipids, that isprostaglandin E2, thromboxanesandplatelet activating factor. In addition, they directly or indirectly causeexpansion of arterioles, synthesisadhesive glycoproteins, activate T- and B-lymphocytes. IL-1 triggers synthesisIL-8, contributing to the chemotaxis of monocytes and neutrophils and the release of enzymes from neutrophils. Decreased synthesis in the liver albuminand increased synthesisacute phase proteins, includingprotease inhibitors, Componentscomplement, fibrinogen, ceruloplasmin, ferritinandhaptoglobin. LevelC-reactive protein, which binds to damaged and dead cells, as well as some microorganisms, can increase 1000 times. There may also be a significant increase in the concentration amyloid Ain serum and its deposition in various organs, leading to secondaryamyloidosis. The most important mediatoracute phase of inflammationisIL-6, althoughIL-1andTNF alpha can also cause the described changes in liver function. IL-1 and TNF alpha enhance each other's influence on local and general manifestations of inflammation, so the combination of these two cytokines, even in small doses, can cause multiple organ failureand persistentarterial hypotension. Suppression of the activity of any of them eliminates this interaction and significantly improves the patient's condition. IL-1 activates T- and B-lymphocytes more strongly at 39*C than at 37*C. IL-1 and TNF alpha cause reduction in non-fat body massandloss of appetiteleading tocachexiawith a longfever. These cytokines enter the bloodstream only for a short time, but it turns out to be enough to launch products IL-6. IL-6 is constantly present in the blood, so its concentration is more consistent with the severity of fever and other manifestations of infection. However, IL-6, unlike IL-1 and TNF-alpha, is not considered a lethal cytokine.

List of used literature

Simbirtsev A.S. [Text] / Cytokines: classification and biological functions // Cytokines and inflammation.-2004.-V.3.-№2.-S.16-23

Kolman, Ya. Visual biochemistry [Electronic resource] / Rem K.-G. - http://www.chem.msu.su/rus/teaching/kolman/378.htm

Cytokines [Electronic resource] - http://nsau.edu.ru/images/vetfac/images/ebooks/microbiology/stu/immun/cytokyni.htm

Knowledge base on human biology [Electronic resource] / Immunology: Cytokines. - http://humbio.ru/humbio/immunology/imm-gal/00142edc.htm

Autocrine-paracrine regulation of the immune response

Tumor necrosis factor

Interleukin 18 (interferon-gamma-inducing factor)

Tumor necrosis factor (TNF) is a specific protein of a group of cytokines - hormone-like substances produced by the immune system. It is of great interest in medicine due to its properties - the ability to cause cell death (necrosis) of intratumoral tissue. This is a real breakthrough in medicine, allowing the use of drugs with TNF for the treatment cancer.

Discovery history

By the beginning of the 20th century, a pattern was discovered in medical practice: in some patients, there was a decrease and / or disappearance of tumor formations after suffering an infection. After that, the American researcher William Coley began to deliberately inject infectious agents (bacteria and their toxins) into cancer patients.

The method was not recognized as effective, as it had a strong toxic effect on the body of patients. But this was the beginning of a whole series of studies that led to the discovery of a protein called tumor necrosis factor. The discovered substance caused the rapid death of malignant cells implanted under the skin of experimental mice. A little later, pure TNF was isolated, which made it possible to use it for research purposes.

This discovery contributed to a real breakthrough in cancer therapy. Previously, with the help of cytokine proteins, it was possible to successfully treat only some oncological formations - skin melanoma, kidney cancer. But a significant advance in this direction has been made possible by the study of the properties possessed by the tumor necrosis factor. Preparations based on it are included in the chemotherapy procedure.

Mechanism of action

Tumor necrosis factor acts on a specific target cell. There are several mechanisms of action:

Through special TNF receptors, a multi-stage mechanism is launched - programmed death. This action is called cytotoxic. In this case, either the complete disappearance of the neoplasm or a decrease in its size is observed.
Through the disruption or complete cessation cell cycle. The cancer cell becomes unable to divide and tumor growth stops. This action is called cytostatic. Usually, the tumor either stops growing or decreases in size.
By blocking the process of formation of new vessels of tumor tissue and damage to existing capillaries. The tumor, devoid of nutrition, necrotic, shrinks and disappears.

There are situations when cancer cells can be insensitive to administered drugs due to mutations. Then the above mechanisms do not arise.

Use in medicine

Tumor necrosis factor is used in the so-called cytokine therapy - treatment with specific proteins produced by blood cells responsible for immunity. The procedure is possible at any stage and is not contraindicated for people with concomitant pathologies - cardiovascular, renal, hepatic. To reduce toxicity, recombinant tumor necrosis factor is used.

Treatment with cytokines is a new and progressively developing direction in oncology. At the same time, the use of TNF is considered the most effective. Since this substance is highly toxic, it is used by so-called regional perfusion. The method consists in the fact that an organ or part of the body infected with a tumor is isolated from the general blood flow with the help of special equipment. Then artificially start blood circulation with the introduced TNF.

Dangerous Consequences

In medical practice, tumor necrosis factor is used with caution. A number of studies prove that TNF is a key component in the development of sepsis, toxic shock. The presence of this protein enhanced the pathogenicity of bacterial and viral infections, which is especially dangerous if the patient has HIV. It has been proven that TNF is involved in the occurrence of autoimmune diseases (for example, rheumatoid arthritis) in which the immune system mistakenly takes the tissues and cells of its body for foreign bodies and damages them.

To minimize high toxic effects, the following measures are observed:

used only locally at the site of tumor formation;
combined with other drugs;
work with mutant less toxic TNF proteins;
injected with neutralizing antibodies.

These circumstances force limited use of tumor necrosis factor. Their treatment must be properly organized.

Diagnostic indicator

A blood test does not register TNF in a healthy body. But its level increases sharply with infectious diseases when pathogen toxins enter the bloodstream. Then it can be contained in the urine. Tumor necrosis factor in the joint fluid is indicative of rheumatoid arthritis.

Also, an increase in this indicator indicates allergic reactions, oncological diseases and is a sign of rejection of transplanted donor organs. There is evidence that an increase in this indicator may indicate noncommunicable diseases eg heart failure, bronchial asthma.

With various immunodeficiencies (including AIDS) and severe viral diseases, as well as injuries and burns, conditions are created that reduce the tumor necrosis factor. A drug that has an immunosuppressive effect will give a similar effect.

Preparations

TNF-based drugs are called targeted drugs - they are able to act aimingly at a specific molecule of a cancer cell, causing the death of the latter. At the same time, the effect on other organs remains minimal, which reduces the toxicity that tumor necrosis factor has. TNF-based drugs are used both independently (monotherapy) and in combination with other drugs.

Today, there are several funds based on TNF, namely:

NGR-TNF is a foreign drug, active substance which is a derivative of TNF. Able to damage the vessels of the tumor, depriving it of nutrition.
Alnorin is a Russian development. Highly effective in combination with interferons.

Refnot is a new Russian drug that also contains thymosin-alpha 1. Its toxicity is extremely low, but its effectiveness is equal to natural TNF and even exceeds it due to its immunostimulating effect. The drug was created in 1990. It successfully passed all the necessary clinical trials and was registered only in 2009, which gave official permission for the treatment of malignant neoplasms.

Self-administration of any drugs based on tumor necrosis factor is strictly prohibited. The treatment of oncological diseases is a complexly organized process that takes place exclusively under the supervision of a specialist.

Tumor necrosis factor is a protein compound whose main function is necrotic damage and resorption of tumor cells. In the body, it is determined in two forms - alpha and beta. TNF-alpha is synthesized by monocytes, macrophages, T-lymphocytes, endothelial and myeloid cells. In healthy people, its content in the blood is insignificant, increased production begins with the penetration of infectious agents and their toxins into the body. The level of this protein in the blood begins to rise as early as 40 minutes after contact with antigens and reaches a maximum after 2-3 hours. TNF-beta is produced by T-lymphocytes, its level in the blood increases two days after infection. In patients with rheumatoid arthritis, molecules of the alpha isomer are determined in the joint fluid, in patients with an acute inflammatory disease - in the urine.

Tumor necrosis factor is a cytokine. In the body, it performs the functions characteristic of this group of compounds: it enhances inflammation, activates immune defenses, has a cytotoxic effect, participates in hematopoiesis processes, and transmits information between the main body systems. It increases the permeability of the walls of blood vessels, increases body temperature, stimulates the production of acute-phase proteins in the liver, enhances the proliferation of B- and T-lymphocytes, and suppresses delayed-type hypersensitivity reactions. In normal hematopoiesis, TNF has a suppressive effect on the tissues in which blood cells are produced, while in oppressed hematopoiesis, it stimulates this process. The cytotoxic effect of this factor is realized through the formation in cell membranes active compounds oxides of nitrogen and oxygen - superoxide radicals. Tumor cells and cells damaged by infectious agents are attacked. Together with the cytotoxic effect, active splitting of adipose tissue is carried out, leading to cachexia. All the main effects in the body are realized by the alpha form of TNF, beta acts locally.

In clinical laboratories, the level of tumor necrosis factor is determined in venous blood. The study is performed by immunoassay methods. The results are used in many areas of clinical practice, as they reflect not only the activity immune system when an infection enters the body, but also the presence of inflammatory processes, tissue damage. The analysis is in demand in immunology, infectious disease, oncology, traumatology and some other areas.

Indications

A blood test for tumor necrosis factor is performed as part of an in-depth study of the immune status. Such an assessment of immunity is indicated for patients with chronic and indolent inflammatory processes, frequent bacterial infections, and progressive immune pathologies. Often, a study is prescribed to monitor rheumatoid arthritis, systemic lupus erythematosus, chronic lung diseases. Other indications for a blood test for TNF include oncological pathologies, severe forms atherosclerosis of the vessels of the brain and heart, injuries and burns. The results of the study reflect the activity inflammatory process, the degree of tissue damage, therefore, they are used to track the dynamics of the patient's condition.

The study of tumor necrosis factor is not used to diagnose specific pathologies, since an increase in its concentration is characteristic of a wide range of infectious, inflammatory and neoplastic diseases and conditions with tissue damage. AT clinical practice the analysis has become widespread due to its high sensitivity - the concentration of the cytokine increases with the onset of the pathological process and changes in proportion to its development. This allows you to use this analysis to monitor the course of diseases, determine treatment tactics.

Preparation for analysis and collection of material

The concentration of tumor necrosis factor is determined in venous blood. Her fence is performed in the morning, on an empty stomach or 3-4 hours after eating. The day before the analysis, you need to stop drinking alcoholic beverages, avoid psycho-emotional stress and physical exertion. One hour before donating blood, you must refrain from smoking. It is also worth informing the doctor about the drugs used so that their influence is taken into account when interpreting the result. Blood is taken from the cubital vein using a puncture. It is collected in a sealed tube and delivered to the laboratory.

The material for the study of tumor necrosis factor is serum, therefore, before analysis, the blood is placed in a centrifuge, where the formed elements and plasma are separated. After that, clotting factors are removed from the plasma, serum remains. The study of TNF is performed by enzyme immunoassay. It consists of two stages. First, antibodies that are specific for TNF are added to the serum. Antigen-antibody complexes are formed. Then an enzyme is added to the mixture, which changes the color of specific complexes. The concentration of tumor necrosis factor is calculated from the color intensity of the sample. Preparation of analysis results takes up to 2 business days.

Normal values

The results of the test for tumor necrosis factor in the blood in most laboratories are expressed in pictograms per milliliter. The norm corridor in this case is from 0 to 8.2 pg / ml. If the measurement is performed in pictograms per liter, then the corridor of reference values is from 0 to 50 pg / l. Physiological factors do not affect the level of TNF in the blood, so if the results deviate from the norm, you should consult a doctor.

Increasing the level of the indicator

There are several reasons for an increase in the level of tumor necrosis factor in the blood. The concentration of this protein increases in infectious diseases. The most pronounced deviations from the norm are determined in patients with

Tumor necrosis factor is an extracellular protein found in the human body. This substance begins to be intensively produced when the internal organs are exposed to pathologies. In medicine, it is referred to as TNF.

TNF characteristic

Tumor necrosis factor alpha and beta are produced by blood cells and the endothelial layer of blood vessels in the brain and other parts of the body. When a foreign substance enters the human body, the level of TNF rises to critical levels after a couple of hours.

The effect of the component is as follows:

Taking part in the reactions of the immune system.
regulation of the inflammatory process.
Influence on the process of hematopoiesis.
cytotoxic effect.

When pathogenic microflora enters the body, the necrosis factor contributes to the activation immune cells. In this regard, the number of blood cells that fight bacteria increases.

The cytotoxic effect of TNF is that it provokes tumor necrosis. A small number of cancer cells are produced in the human body throughout life, so the factor is necessary for the rapid necrosis of cancer.

Assignment of analysis for TNF

A laboratory blood test to assess the concentration of tumor necrosis factor is not so common. The expediency of such a diagnosis of the state of the body is recognized only in specific cases. Indications for analysis are:

Prolonged course of inflammatory and infectious processes.
Autoimmune pathologies.
Oncological neoplasms.
Burn diseases.
Injuries.
Rheumatoid arthritis.

An increased amount of protein plays an important role not only in detecting pathological processes in the body, but also in predicting a particular disease.

Deviations from the norm

Research that shows possible deviations TNF, held in the morning. Human blood is taken from a vein. Before the analysis is not allowed to drink tea or coffee. No food should be eaten 8 hours before the procedure.

If there is an increase in the content of the protein in question in the blood serum, then the following diseases may develop:

infectious diseases.
Sepsis.
Burns.
Allergic reaction.
Autoimmune pathologies.
Multiple sclerosis.
Meningitis.
Encephalitis.
Psoriasis.
Diabetes.
Myeloma and other formations of the circulatory system.
Shock state.

It is possible not only to increase the concentration of the necrosis factor, but also to decrease it. A decrease in the level can provoke immunodeficiency syndromes, a cancerous tumor internal organs taking certain medications.

Medicines with TNF

Tumor necrosis factor in a malignant process can be used as a medicinal product. But to date, this practice is used only in specific clinical trials, since doctors do not yet have complete information about this type of medication.

There are several agents that include tumor necrosis factor. These include Refnot, Remizad, Enbrel, Golimumab and others.

In the treatment of cancer, a strict dosage of drugs containing tumor TNF is established. It is very important to follow it. Scientists in the course of research have found that with the wrong tactics of TNF protein therapy, at a certain point, it takes the side of oncology and contributes to its development. Therefore, the use of such drugs should be carried out under the strict supervision of doctors.

Only in the clinic decide the question of the appropriateness of using the necrosis factor in a particular case, the duration and dosage of medications. It is strictly forbidden to treat the disease on your own.

Thus, tumor necrosis factor performs important functions in the human body, helping to cope with cancer cells. But its use for medical purposes is currently not common.

Scientific editor: M. Merkusheva, PSPbGMU im. acad. Pavlova, medical business.
September, 2018.

Synonyms: Tumor necrosis factor, TNF, Tumor necrosis factor - alpha, TNF-alpha, сachectin.

General information

Tumor necrosis factor (TNF) is considered an important component that promotes the destruction of cancer cells. This protein (or a combination of them) triggers immune response body to any external stimulus, whether it be inflammation, infection, injury or tumor.

TNF analysis allows you to determine the presence and / or stage of cancer or other systemic disease and choose an effective treatment strategy.

For the first time, this component was found in the blood of laboratory mice after a complex of routine vaccinations.

TNF plays a role in the development of:

autoimmune diseases ( rheumatoid arthritis),
ischemic brain injury
multiple sclerosis,
dementia in AIDS patients,
considered one of the important markers of damage to the liver parenchyma in hepatitis C, etc.

Techniques are being developed to use anti-TNF monoclonal antibodies for the treatment of sepsis, inflammatory diseases and tumors.

TNF is a hormone-like protein (cytokine) that is produced by white blood cells - leukocytes. It interferes with the metabolism of fats and carbohydrates and causes exhaustion and cachexia in patients with tumors and long-term infectious diseases, affects blood coagulation processes, is responsible for the functioning of endothelial cells (cells lining the walls of blood vessels from the inside), etc. activates the production of proteins of the acute phase of inflammation in the liver, enhances the flow of T- and B-lymphocytes from the bone marrow into the blood and migration to the focus of inflammation, plays a major role in the development of sepsis and septic shock.

There are 2 types of TNF: alpha and beta.

TNF-alpha is rarely detected in the blood healthy person, only in case of penetration of pathological microorganisms, poisons. The response time of the body is about 40 minutes, and after 1.5-3 hours the concentration of TNF-alpha in the blood serum reaches its peak.
TNF-beta is detected in the blood only 2-3 days after contact with the antigen (irritant).

The biological effect of TNF depends on its concentration: at low concentrations, it acts mainly at the site of production, at medium concentrations, entering the blood, it acts as a hormone, providing a pyrogenic effect, stimulating the formation of phagocytes, increases blood clotting, reduces appetite, and at high concentrations, it can lead to sepsis.

TNF, together with other cytokines, plays a central role in the development of neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease. Activated neuroglial cells begin to synthesize TNF, trigger inflammation in the CNS and destruction of neurons.

TNF in oncology

Experiments with mice made it possible to establish the dependence of the oncoprocess on the concentration of TNF in the body - the higher its level, the faster the cancerous tissues die. Tumor necrosis factor activates special receptors that detect a malignant cell, block its further division and contribute to its death (necrosis). In the same way, TNF acts on cells affected by viruses and other pathogenic microorganisms. At the same time, the surrounding healthy tissues are not involved in the process of destruction of pathological cells.

In addition to the fact that TNF has a pronounced cytotoxic (antitumor) effect, this protein:

participates in the self-regulation of the immune system, activates the defenses;
- responsible for the following processes in the body:
- migration (movement) of immunity cells (leukocytes);
- apoptosis (disintegration and death of malignant cells);
- blocking angiogenesis (the formation and growth of tumor blood vessels);
can affect cancer cells that are resistant to chemotherapy drugs.

The analysis for TNF consists in determining the concentration of the alpha form of the protein in the blood serum. The disadvantage of the technique is the low specificity, i.e. the inability to establish a specific pathology. Therefore, an accurate diagnosis requires a number of other laboratory research (general analysis blood and urine, CT, ultrasound, ECG, X-ray, etc.).

Indications for analysis for TNF

Your doctor may order this test to evaluate general condition immune system with regularly recurring systemic diseases and relapses of autoimmune pathologies.

Also, this examination is quite informative in the diagnosis of the following diseases:

chronic lung diseases;
burns and injuries;
connective tissue pathology;
cancer processes;
atherosclerosis of the vessels of the brain and heart, ischemic disease (CHD), chronic heart failure;
autoimmune disorders (scleroderma, systemic lupus erythematosus, etc.);
pancreatitis in acute form(inflammation of the pancreas);
liver damage (alcohol intoxication), damage to its parenchyma in hepatitis C;
septic shock (complication of infectious diseases);
endometriosis (growth of tissues of the inner walls of the uterus);
rejection of an implant or graft after transplantation;
neuropathies (pathological processes in the nerves).

Which doctor prescribes the analysis

Issues a referral for analysis and decrypts the results

oncologist,
infectiologist,
immunologist,
general doctor.

Norm for TNF

Important! Regulations vary depending on the reagents and equipment used in each particular laboratory. Therefore, when interpreting the results, it is necessary to use the standards adopted in the laboratory where the analysis was taken.

However, in modern laboratories, the value is considered to be the norm.

It should be taken into account that this indicator is studied in dynamics, i.e. Several tests must be done to obtain reliable results.

Important! The interpretation of the results is always carried out in a complex manner. It is impossible to make an accurate diagnosis on the basis of only one analysis.

TNF increased

Exceeding the norm of TNF is most often observed in the following conditions:

presence of infection and viral diseases(endocarditis, hepatitis C, tuberculosis, herpes, etc.);
shock after injury, burns;
burn disease (burns from 15% of the entire surface);
DIC syndrome (a blood clotting disorder in which blood clots form in small vessels);
sepsis (severe intoxication of the body with pathogenic microflora and its metabolic products, mainly gram-negative);
autoimmune diseases (lupus erythematosus, rheumatoid arthritis, scleroderma, etc.);
allergic processes in the body, incl. relapse of bronchial asthma;
graft rejection after transplantation;
psoriasis (non-infectious dermatosis);
oncological processes in the body;
multiple myeloma (plasma cell tumor);
dementia against the background of atherosclerosis of cerebral vessels;
hemodynamic disturbances (decrease in the force of contractions of the heart, high vascular permeability, low cardiac output, etc.);
coronary atherosclerosis (damage to the blood vessels that feed the heart);
chronic inflammation of the bronchi (bronchitis);
collagenosis (systemic or local damage to the connective tissue);
abscesses and inflammation of the pancreas;
obesity;
fungal mycosis.

High TNF in pregnant women indicates violations of intrauterine formation and development of the fetus or infection of the amniotic fluid, as well as the threat of miscarriage or premature birth.

Decreasing values

A decrease in the TNF index is observed in the following cases:

congenital or acquired human immunodeficiency, incl. AIDS;
oncology of the stomach;
pernicious anemia (impaired hematopoiesis due to vitamin B12 deficiency);
heavy infectious diseases viral etiology;
atopic syndrome (the patient has asthma or atopic dermatitis with allergic rhinitis).

A decrease in the concentration of TNF can be facilitated by the intake of hormones, incl. corticosteroids, cytostatics, antidepressants, immunosuppressants, etc.

Preparation for analysis

To determine TNF, venous blood serum in a volume of up to 5 ml is required.

Biomaterial sampling is carried out in the morning (at the peak of TNF concentration) and on an empty stomach. The last meal should be made at least 8-10 hours ago. It is also forbidden to drink any liquid other than ordinary non-carbonated water.
On the eve of blood sampling and half an hour immediately before the procedure, it is necessary to observe a rest mode. Forbidden physical exercise, sports training, weight lifting, brisk walking, excitement and stress.
The test is performed before the other laboratory tests(ultrasound, X-ray, CT, MRI, fluorography, etc.).
It is advisable not to smoke 2-3 hours before the manipulation, and on the eve it is forbidden to take alcoholic beverages, drugs, steroids.