TNF and acute respiratory distress syndrome: Among all potential targets, tumor necrosis factor-α (TNF) is one of the strongest candidates for such interventions—it is one of the earliest expressed “gate-keeper” cytokines in response to almost any potentially damaging situation, modulating subsequent inflammatory responses, and has been repeatedly implicated in the development and progression of ARDS (8), including direct effects on pulmonary edema formation and clearance.