TNF and myeloid sarcoma: In MS, CNS-restricted proinflammatory cytokines (e.g. TNF-α) made by microglia are upregulated, whereas anti-inflammatory cytokines (e.g. IL-10) are suppressed.16 Melanocortins bound to MC1Rs on activated microglia suppress production of the proinflammatory mediators TNF-α, IL-6 and nitric oxide.1,9 These findings suggest yet another possible disease-ameliorating role for ACTH in MS.