TNF and major depressive disorder: These pathways include the cAMP response element-binding/activating transcription factor (CREB/ATF) family of transcription factors (TFs),18, 22 the glucocorticoid receptor (GR)25, 26, 27, 28, 29, 30 and early growth response (EGR) family TFs.31, 32, 33, 34 Other studies have linked MDD to altered activity of circulating mediators that regulate TF activity, including glucocorticoids,35, 36, 37, 38 pro-inflammatory cytokines, such as interleukin (IL)-1β, IL-6 and tumor necrosis factor-α,36, 37, 39, 40 Type I interferons37, 41, 42, 43 and oxidative stress.40, 44, 45, 46