TNF and asthma: Patients with refractory asthma have evidence of up-regulation of the TNF-α axis since they had increased expression of membrane-bound TNF-α, TNF-α receptor 1, and TNF-α–converting enzyme by peripheral-blood monocytes and a 10 weeks of treatment with the soluble TNF receptor, etanercept, was associated with a significant improve in non specific bronchial hyperresponsiveness, post bronchodilator FEV1 and asthma-related quality of life[23].