TNF and chronic obstructive pulmonary disease: Similarly, the higher cumulative dose of ICSs (1.2 mg/day x 180day = 0.21 gram > 0.13gram) have a protective effect of the system inflammation (IFNγ, TNF-α), [61] in COPD-related disease such as lung cancer [62], this protective effect was not found in the lower dose (< 0.21 gram).