TNF and acute pancreatitis: Its pathogenesis is not completely understood (Zerem, 2014), but MLCK expression is significantly increased in rat models of acute pancreatitis (Shi et al., 2014), and elevation of tumor necrosis factor (TNF)-α in severe acute pancreatitis has been shown to mediate MLCK-dependent regulation of the cytoskeleton, leading to destruction of the endothelial barrier function (Shi et al., 2014; Yu et al., 2016).