TNF and Keratoconjunctivitis sicca: Massingale et al. reported increased mRNA expression of IL-1β, IL-6, IL-8, and TNF-α in conjunctival IC samples in dry eye patients as compared to normal controls and the fold increase (1.32 to 2.48) correlated well with the fold increase (1.55 to 2.90) of the cytokine tear levels (73).