Our group has recently shown that serum levels of interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF alpha) were higher and matrix metalloproteinase 9 (MMP-9) and vascular endothelial growth factor (VEGF) lower in patients with severe and very severe COPD compared with smoker and non-smoker controls without airflow obstruction9. Here, TNF is linked to chronic obstructive pulmonary disease.