TNF and endothelial dysfunction: In particular, TNF-α is a pleiotropic cytokine that is involved in atherothrombosis in several pathways: TNF-α increases the expression of adhesion molecules by endothelium and as well enhances leukocyte adhesion and rolling (46), and it is involved in the implementation of endothelial dysfunction via increase of reactive oxygen species production and impairment of NO-mediated vasodilation (47–50).