TNF and Sepsis: Numbers of immature, or band, neutrophils are also altered during sepsis, and increase in these cells is known as a “left shift.” A “left shift” is significant because compared to mature neutrophils, immature neutrophils have a relatively longer life span and are resistant to spontaneous apoptosis, have higher basal levels of pro-inflammatory mediators compared to anti-inflammatory mediators (i.e., TNFα/IL-10 ratio), demonstrate reduced migration in response to chemoattractants, produce less ROS, and have decreased phagocytic and bactericidal activity (162, 163).