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Tumor necrosis alpha (<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u03b1) is a cytokine involved in systemic inflammation and clinical utilization of its antagonists has revolutionized treatment of juvenile rheumatoid and psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, and plaque psoriasis. Clinical utility has also been demonstrated for use against steroid\u2010refractory graft\u2010vs\u2010host disease and other immune\u2010mediated conditions. Currently, five anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u03b1 agents are approved by the European Medicines Agency (<jats:styled-content style=\"fixed-case\">EMA<\/jats:styled-content>), including the monoclonal anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> antibodies infliximab, adalimumab, golimumab and certolizumab pegol along with etanercept, a <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u03b1\u2010receptor\/IgG\u2010Fc fusion protein. Theoretical considerations related to their mode of action and clinical observations suggest that opportunistic infectious complications should be seriously considered as possible adverse events of macromolecular immunosuppressants. The purpose of this review is to critically analyze the literature on invasive fungal infections (<jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>s) occurring in association with <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u03b1 inhibitors alone or in combination with other immunosuppressive agents, with a focus on pediatric patients, and to provide a framework of evaluating the risk for <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>s in this population.<\/jats:p>","DOI":"10.1111\/myc.12576","type":"journal-article","created":{"date-parts":[[2016,10,21]],"date-time":"2016-10-21T05:36:44Z","timestamp":1477028204000},"page":"222-229","source":"Crossref","is-referenced-by-count":42,"title":["Invasive fungal infections in pediatric patients treated with tumor necrosis alpha (<scp>TNF<\/scp>\u2010\u03b1) inhibitors"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4294-2605","authenticated-orcid":false,"given":"Athanasios","family":"Tragiannidis","sequence":"first","affiliation":[{"name":"Second Department of Pediatrics AHEPA University General Hospital Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8153-9643","authenticated-orcid":false,"given":"Ioannis","family":"Kyriakidis","sequence":"additional","affiliation":[{"name":"Second Department of Pediatrics AHEPA University General Hospital Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilse","family":"Z\u00fcndorf","sequence":"additional","affiliation":[{"name":"Institute of Pharmaceutical Biology Goethe\u2010University of Frankfurt  Frankfurt am Main Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas H.","family":"Groll","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology Center for Bone Marrow Transplantation Infectious Disease Research Program University Childrens Hospital  Muenster Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,10,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00040-08"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2009.08.006"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2009.02.007"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/DHPS.S28801"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.riam.2009.04.001"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2147\/AHMT.S8163"},{"key":"e_1_2_10_8_1","first-page":"CD008794","article-title":"Adverse effects of biologics: a network meta\u2010analysis and Cochrane overview","volume":"2","author":"Singh JA","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2010.11.009"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2010.01.006"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.2217\/imt.13.10"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2005.05397.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2006.02.001"},{"key":"e_1_2_10_14_1","unstructured":"European Medicines Agency (EMEA).Remicade. 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