TNF and dilated cardiomyopathy: In another study, Wu et al. reported that TLR4 activation can downregulate the optic atrophy (OPA) 1 in the inner mitochondrial membrane by elevated TNF-α level and ROS stress, induce mitochondrial dynamic imbalance and damage, and contribute to the progress of experimental autoimmune myocarditis to dilated cardiomyopathy [37].