Tumour Necrosis Factor ALPHA

Immunity

Report in 168Hrs

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No Fasting Required

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Inflammatory cytokine measurement.

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Tumour Necrosis Factor Alpha (TNF-α) - Comprehensive Test Guide

Why is it done?
- Test Measurement: TNF-α is a pro-inflammatory cytokine produced primarily by macrophages and T-cells. This test measures the serum concentration of TNF-α to assess immune and inflammatory status.
- Primary Indications: Suspected inflammatory conditions (rheumatoid arthritis, inflammatory bowel disease), sepsis and severe infections, chronic inflammatory diseases, monitoring TNF-inhibitor therapy effectiveness, assessment of immune system dysfunction
- Typical Timing: Performed during acute inflammatory episodes, as baseline before anti-TNF therapy, during routine monitoring of chronic inflammatory conditions, and in cases of unexplained fever or systemic inflammation
Normal Range
- Reference Values: Less than 1.5-2.4 pg/mL (picograms per milliliter) is typically considered normal; reference ranges vary by laboratory and assay method used
- Units of Measurement: pg/mL (picograms per milliliter) or sometimes ng/L (nanograms per liter)
- Interpretation Guide: Normal (<1.5-2.4 pg/mL) indicates minimal inflammatory activity; Elevated (>2.4 pg/mL) suggests active inflammation or immune system activation; Significantly elevated levels (>10 pg/mL) may indicate severe infection or acute inflammatory response
- What Normal vs Abnormal Means: Normal levels indicate adequate immune regulation without excessive inflammatory response. Abnormal elevations suggest active inflammatory disease, infection, tissue damage, or immune dysregulation requiring further investigation and possible treatment
Interpretation
- Mildly Elevated (2.5-5 pg/mL): Suggests mild inflammatory response; may occur in chronic inflammatory conditions, minor infections, or stress; warrants clinical correlation with symptoms
- Moderately Elevated (5-10 pg/mL): Indicates moderate inflammatory activity; consistent with active autoimmune disease, moderate infection, or acute inflammatory episodes; requires clinical assessment and possible intervention
- Significantly Elevated (>10 pg/mL): Suggests severe inflammation, severe infection/sepsis, acute tissue damage, or uncontrolled autoimmune disease; requires urgent clinical evaluation and prompt intervention
- Factors Affecting Results: Stress, physical exertion, time of day (circadian variation), current medications (especially immunosuppressants), recent infections, active exercise, smoking status, obesity, and ongoing TNF-inhibitor therapy can all influence TNF-α levels
- Clinical Significance: TNF-α is a key prognostic marker in sepsis, may predict severity in infectious diseases, helps assess disease activity in rheumatologic conditions, indicates effectiveness of anti-TNF therapy, and may correlate with prognosis in malignancies
Associated Organs and Medical Conditions
- Primary Organ Systems: Immune system (primary source), joints, gastrointestinal tract, cardiovascular system, central nervous system, and lungs are most significantly affected by TNF-α dysregulation
- Associated Inflammatory Conditions: Rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease (Crohn's disease and ulcerative colitis), psoriasis, systemic lupus erythematosus, vasculitis, and other autoimmune conditions
- Infectious Conditions: Sepsis, tuberculosis, bacterial/viral meningitis, severe pneumonia, endotoxemia, and chronic infections; elevated TNF-α is a marker of severe systemic infection
- Other Associated Diseases: Congestive heart failure, diabetes mellitus, obesity, metabolic syndrome, depression, Alzheimer's disease, and various malignancies; chronic TNF-α elevation associated with cachexia and tissue wasting
- Potential Complications: Excessive TNF-α can cause tissue destruction, joint damage (in rheumatoid arthritis), intestinal perforation (in IBD), shock in sepsis, myocardial dysfunction, vascular permeability leading to fluid extravasation, and multi-organ failure if severely elevated
Follow-up Tests
- Complementary Inflammatory Markers: C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), interleukin-1 (IL-1), and procalcitonin to assess overall inflammatory status and infection severity
- Immunological Assessment: Complete blood count (CBC), immunoglobulin levels, complement levels (C3, C4), and flow cytometry for immune cell profiling if autoimmune disease suspected
- Disease-Specific Monitoring: Rheumatoid factor (RF), anti-CCP antibodies, ANA panel for autoimmune conditions; fecal calprotectin for IBD; anti-TNF antibody levels when on TNF-inhibitor therapy
- Organ Function Tests: Liver function tests, renal function tests, cardiac markers, and coagulation studies to assess end-organ damage from inflammatory response
- Imaging Studies: X-rays, ultrasound, CT scans, or MRI depending on suspected conditions and organ involvement
- Monitoring Frequency: Baseline before TNF-inhibitor therapy, repeat testing at 4-6 weeks to assess response, then every 3-6 months during maintenance therapy, or more frequently if disease exacerbation suspected
Fasting Required?
- Fasting Status: NO - Fasting is not required for TNF-α testing; blood can be collected at any time of day with or without food
- Sample Collection Requirements: Standard serum or plasma collection via venipuncture; typically 2-5 mL of blood is required; samples should be collected into appropriate tubes as directed by the laboratory
- Timing Considerations: Morning collection preferred for consistency due to circadian variation; avoid collection immediately after strenuous exercise or acute stress if possible; sample should be processed promptly (within 1-2 hours)
- Medication Interactions: NO medications need to be stopped before testing; however, document all current medications including corticosteroids, NSAIDs, TNF-inhibitors, immunosuppressants, and antibiotics as these can affect TNF-α levels
- Patient Preparation: Patient should be seated comfortably for at least 5 minutes before blood collection; inform patient that fasting is not necessary; continue all regular medications unless specifically instructed otherwise by physician; avoid strenuous exercise 24 hours before testing if possible
- Special Instructions: Samples must be kept at appropriate temperature; do not expose to extreme heat or cold; if delayed processing, samples may need to be refrigerated; consult with laboratory for specific handling requirements

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