TNF and dengue disease: While the pathophysiology behind severe dengue is not fully understood, it is accepted that dengue hemorrhagic fever and severe dengue result from a cytokine-mediated pathology (cytokine storm) that occurs because of the unbalanced production of various soluble and short-lived immune factors, such as TNF-α, VEGF-A, IL-6, IL-8, IL-10, CCL2, and CXCL10, that are produced by immune cells [10].