TNF and viral myocarditis: In 2004, the TNF-α mRNA and TNF-α protein had been firstly reported to be significantly more present in viral myocarditis patients than in nonviral myocarditis, accompanying the histologic change of prominent myocardial necrosis compared to TNF-α-negative cases (Calabrese et al., 2004), suggesting that TNF-α mRNA and protein are overexpressed with viral myocarditis of any etiology.