Increased peripheral blood monocytes activity and elevated expression of TNF-α which was found to be correlated with liver disease activity (Child-Pugh stage B and C) were reported.33 TNF-α is a potent mediator of inflammation and sepsis34 and has a pleiotropic effect on a wide variety of cells including endothelial cells.35 Furthermore, data revealed the circulating levels of TNF-α in both groups of patients were strongly correlated with each of sICAM-1 and sVCAM-1 values in these patients. The gene discussed is TNF; the disease is liver disorder.