TNF and influenza: We have shown that when combined with influenza vaccine, a TLR4 agonist as a vaccine adjuvant improved the cell-mediated immune response in older adult PBMC through stimulation of inflammatory cytokines (IL-6 and TNFα) in myeloid DC, and was associated with a 10-fold reduction in IL-10 levels and an increase in GrzB produced by CD8 T cells in response to influenza challenge (89).