Thus, CD14+ monocytes do contribute to pathophysiological mechanisms in ACD.49, 50, 51, 52 Upon activation cells may produce cytokines like TNF or other factors, such as ROS or nitric oxide (NO), thereby cotriggering inflammatory processes.53, 54, 55, 56, 57 In addition, monocytes are capable of efficiently presenting Ni2+-specific epitopes to Ni2+-reactive human T cells17, 58 and producing anti-microbial factors that may be directly affected by Ni2+. The gene discussed is TNF; the disease is granular corneal dystrophy type II.