These associations between pre-sepsis immune dysfunction and mortality are supported by studies showing that sepsis impairs production of IL-1, IL-6, TNF-α [67], IL-12 [68], and IFN-γ [69] and suggesting that this sepsis-induced immunosuppressive state may be augmented by release of IL-4 and IL-10 [69]. This evidence concerns the gene TNF and immune system disorder.