摘要The pleiotropic regulatory effect of tumor necrosis factor-alpha(TNF-α),an essential cytokine involved in immune regulation,is of significant importance in the immune response.TNF-α inhibitors have been widely used in rheumatoid arthritis(RA)and other autoimmune diseases since their introduction into clinical practice.However,the tradeoff between its excellent efficacy and adverse drug reactions(ADR)remains a problem.T cells,especially the T helper cell 17(Th17)/regulatory T(Treg)cells balance,are crucial for the treatment of autoimmune diseases including RA.This review explores the mechanisms by which TNF-α/TNF receptor(TNFR)signaling induces Th17/Treg imbalance in RA.This review synthesizes current knowledge to facilitate an improved understanding of the causes of ADR,such as infection caused by TNF-α inhibitors in clinical practice.Moreover,our findings offer a reference for exploring potential TNF-α/TNFR signaling inhibitory strategies from the perspective of regulating T cell balance.