BACKGROUND: The role of transforming growth factor 1 (TGF-1) and tumor necrosis factor ␣ (TNF-␣) in asthma is unclear. The aim of this study was to assess the relationships among polymorphisms, clinical phenotypes, and the serum levels of TGF-1 and TNF-␣. METHODS: Polymorphisms of promoter of TGF-1 (C-509T locus) and TNF-␣ (G-308 A locus; rs 1800629) in 217 asthmatic patients and 110 healthy controls were evaluated. Pulmonary function, total immunoglobulin E (IgE), specific IgE antibodies, total eosinophil counts, TGF-1, and TNF-␣ were assessed. RESULTS: The genetic polymorphisms of TGF-1 promoter and TNF-␣ were significantly associated with asthma. Subjects with more severe asthma had higher serum levels of TGF-1 and TNF-␣. In asthmatic subjects the TGF-1 of atopic subjects was higher than those without atopy. All studied subjects (asthma plus control) were divided into 4 groups by mean value of TGF-1 or TNF-␣. The high values of TGF-1 or TNF-␣ were defined by higher than the mean values of the studied subjects of TGF-1 (392.42 pg/mL) and TNF-␣ (55.86 pg/mL). The FEV 1 of the group with high TGF-1 plus low TNF-␣ was lower than that in the group with low TGF-1 plus low TNF-␣. The lowest FEV 1 was in the group with high TNF-␣ and high TGF-1. CONCLUSIONS: The genetic polymorphisms of TGF-1 and TNF-␣ are associated with asthma. TGF-1 modulates atopy. Both TGF-1 and TNF-␣ modulate clinical severity and airway obstruction, in an additive manner.