TNF and Cowden disease: Together, GWT may alleviate clinical manifestations of CD by (1) decreasing the expression of inflammatory cytokines such as TNF-α and IL-1β as well as of IL-12, which is increased in this disorder and enhances T helper 1 response [38], and (2) strengthening the antioxidant defense system by increasing SOD activity, which is presumably necessary to prevent MTX-induced oxidative damage.