TNF and tuberculosis: TNF-α, a pro-inflammatory cytokine, is mainly produced by monocytes and macrophages and has a central role in the immune response to M. tuberculosis by recruiting immune cells, enhancing the anti-TB activity of macrophages, and promoting granuloma formation.[4] It has been postulated that sustained immune activation in the CSF causes the disproportionate inflammatory response that leads to PR/IRIS.