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Tumour necrosis factor-alpha concentration in severely asthmatic children.

We assessed tumour necrosis factor-alpha (TNF-alpha) concentrations in 80 asthmatic children, 26 with severe asthma in early-phase reaction, 26 with severe asthma in late-phase reaction, 28 with severe asthma controlled in between attacks with oral prednisone and 20 matched control children. TNF-alpha was measured in patients' plasma and in a supernatant of lipopolysaccharide-stimulated (LPS) peripheral blood mononuclear (PBM) cells. TNF-alpha concentrations in plasma and the supernatant of LPS-stimulated cells were positively correlated and the concentration also correlated positively with the time lapse between the start of the asthma attack and the time of blood sampling. TNF-alpha concentration was significantly higher in the late-phase reaction group compared to the other groups, indicating a need to counteract its release and/or effects early in asthma patients.