k Tumor necrosis factor (TNF) is an important cytokine for host defense against pathogens but is also associated with the development of human immunopathologies. TNF blockade effectively ameliorates many chronic inflammatory conditions but compromises host immunity to tuberculosis. The search for novel, more specific human TNF blockers requires the development of a reliable animal model. We used a novel mouse model with complete replacement of the mouse TNF gene by its human ortholog (human TNF [huTNF] knock-in [KI] mice) to determine resistance to Mycobacterium bovis BCG and M. tuberculosis infections and to investigate whether TNF inhibitors in clinical use reduce host immunity. Our results show that macrophages from huTNF KI mice responded to BCG and lipopolysaccharide similarly to wild-type macrophages by NF-B activation and cytokine production. While TNF-deficient mice rapidly succumbed to mycobacterial infection, huTNF KI mice survived, controlling the bacterial burden and activating bactericidal mechanisms. Administration of TNF-neutralizing biologics disrupted the control of mycobacterial infection in huTNF KI mice, leading to an increased bacterial burden and hyperinflammation. Thus, our findings demonstrate that human TNF can functionally replace murine TNF in vivo, providing mycobacterial resistance that could be compromised by TNF neutralization. This new animal model will be helpful for the testing of specific biologics neutralizing human TNF.T umor necrosis factor (TNF) is critical for resistance against intracellular bacterial infections; however, its dysregulation may be associated with the development of human immunopathologies (1-5). Anti-TNF therapies have shown their efficacy for the treatment of autoimmune inflammatory diseases, such as rheumatoid arthritis and Crohn's disease, and are being explored for the treatment of other severe human pathologies, such as chronic obstructive pulmonary disease (6-8). However, the complete blockade of TNF has confirmed the essential role of TNF in the control of tuberculosis (TB) infection, as treated patients develop both TB and nontuberculous mycobacterial diseases (9-12). TB is still a major health problem newly affecting in its active form nearly 9 million people every year. One-third of the global population is considered to be infected by Mycobacterium tuberculosis in a latent form (13). M. bovis BCG is used for vaccination in countries with a high TB incidence and appears to control severe forms of tuberculosis in children but fails to prevent TB in adults (14).TNF is initially synthesized as a membrane protein released under activation by infectious and inflammatory stimuli. Two types of TNF inhibitors blocking membrane and soluble TNF are currently used to treat inflammatory diseases and comprise anti-TNF antibodies (infliximab, adalimumab, certolizumab, etc.) and soluble TNF receptor 2 (sTNFR2; etanercept) (15). These drugs have distinct neutralization efficacies in human diseases, and they are associated with distinct risks of TB reactivation,...