TNF and Arthritis: D-mannose is a simple hexose sugar with a molecular weight of 180.2 and is known to: decrease inflammatory processes during wound healing [76], reduce oxidative bursts required during inflammation [106], suppress adjuvant-induced arthritis in a rat model [107], inhibit LPS-induced IL-1β, TNF-α decrease NF-kB/p65 critical for proinflammatory cytokine expression, and decrease leukocyte influx following intratracheal instillation of LPS, which is a model of sepsis-associated acute lung injury and respiratory distress syndrome [77,108].