VCAM1 and atherosclerosis: TNF-α is a potent pleiotropic cytokine which exerts inflammatory effects in the development of atherosclerosis: (1) TNF-α promotes macrophages to uptake oxidized LDL and to form foam cells, (2) TNF-α promotes leukocyte recruitment by inducing endothelial VCAM-1 expression, (3) TNF-α promotes chemotaxis by increasing the production of MCP-1from the endothelial cells, (4) TNF-α directly impairs nitric oxide bioavailability by inhibiting endothelial nitric oxide synthase and increasing reactive oxygen species [23] [24].