TNF and Sepsis: For example, in the serum of patients with severe sepsis, the combined results of four clinical studies show that five miRs are strongly upregulated (miR-486, -182, -15b, -223 and -483), while 12 miRs are downregulated including miR-146 (Vasilescu et al., 2009; Wang et al., 2010; Wang et al., 2012; Tudor et al., 2014), a well-documented anti-inflammatory miR-146 that reduces the expression and activity of several pro-inflammatory mediators such IL1, TNFα, IRAK1, TRAF6 and NF-κB (Saba et al., 2014).