The activity of TNF-alpha in the serum was determined with ELISA basing on 2 monoclonal antibodies varying by epitopic specificity in 25 patients with pulmonary tuberculosis and 4 patients with chronic nonspecific respiratory diseases. TNF-alpha varied with tuberculosis severity and prognostic factors. Its level appeared the highest in fibrocavernous tuberculosis (405.0 +/- 82.9 pg/ml) against 355.0 +/- 32.5 pg/ml in tuberculoma. In the progressive disease TNF-alpha serum level was lower than in stabilization or inactive tuberculosis (334.6 +/- 36.8 pg/ml against 443.7 +/- 32.1). Low TNF-alpha concentrations indicate an adverse run of tuberculosis associated with destruction, intoxication and bacterial discharge.

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