TNF and allergic disease: For instance, yeast EVs released from cocultures of dendritic cells (DCs) and Malassezia sympodialis induce the production of tumor necrosis factor alpha (TNF-α) and higher levels of interleukin 4 (IL-4) by peripheral blood mononuclear cells (PBMCs) from patients with atopic eczema compared to control PBMCs, displaying an allergic reaction (19, 20).