• Laurent Guilleminault, Philippe Carré, Frédérique Beau-Salinas, Camille Taillé, Philippe Dieudé, Bruno Crestani, Patrice Diot, and Sylvain Marchand-Adam.
• Service de pneumologie et exploration fonctionnelle respiratoire, Hôpital Bretonneau, Tours, France. guillel@free.fr
• Chest. 2011 Oct 1;140(4):1068-71.

AbstractWe report five cases of asthma unmasked by anti-tumor necrosis factor (TNF)-α-blocking drugs. Asthma symptoms appeared within an average of 4 months (range 1-24 months) after starting the anti-TNF-α treatment for inflammatory disease. The patients did not appear to be predisposed to asthma except for one patient who had asthma during childhood. Four patients stopped anti-TNF-α-blocking drugs with an improvement of symptoms within 1 to 5 months. In the patient with a history of childhood asthma, respiratory symptoms recurred when another anti-TNF-α therapy was started. Asthma control was achieved with inhaled steroids, allowing anti-TNF-α treatment to continue. The biotherapy was maintained for the fifth patient in association with inhaled steroids. The pathophysiologic mechanisms are unknown but are probably more complex than the T helper 1/T helper 2 imbalance suggested in the literature, and further studies are required.

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