TNF and Sepsis: For instance, there is convincing research linking genetic variation with the host response to sepsis and trauma, but there is limited work investigating this in surgery.15–18 Single nucleotide polymorphisms (SNPs) are the commonest form of genetic variation,19 and many have been linked to disease.20 For instance, polymorphisms associated with high TNF-α have been associated with sepsis.18,21TNF-α is a critical cytokine regulating acute inflammation via activation of immune cells, release of large amounts of inflammatory mediators, downstream signalling and endocrine effects.22