In the first phase, systemic inflammatory response syndrome (SIRS) and MOF occur frequently and are the main cause of death.[12] With the gradual insight of its pathogenesis, SAP induces elevated levels of tumor necrosis factor-alpha (TNF-alpha) and Interleukin-1B (IL-1b) in the circulatory system and further induces production of IL-6 and IL-8. Here, TNF is linked to systemic inflammatory response syndrome.