TNF and malnutrition: Malnutrition promotes the phenotypic transformation of immune cells to pro-inflammatory phenotypes (35, 36), secreting pro-inflammatory cytokines such as IL-1β, IL-6, IL-8, TNF-α, and IL-2, while anti-inflammatory cytokines such as IL-1 receptor antagonists, IL-4, IL-10, and IL-13 decrease (37).