TNF and endothelial dysfunction: The activation of transcription factors such as nuclear factor kappa B (NF-kB) and the interferon-sensitive response element (ISRE) results in the production of interleukins, pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), and vascular cell adhesion molecule-1 (VCAM-1), contributing to inflammation and endothelial dysfunction, leading to the progression of chronic illness [15,16,17,18,19].