TNF and pneumococcal meningitis: In a prospective clinical trial in Mongolian gerbils, tumor necrosis factor-alpha administered via continuous 8-day intrathecal flow induced SNHL across all frequencies compared to phosphate-buffered saline delivered intrathecally in controls and tumor necrosis factor-alpha antibody injected intraperitoneally reduced SNHL in the pneumococcal meningitis model [46].