TNF and rheumatoid arthritis: The known proinflammatory effect of m/lEVs and m/lEV-ICs from patients with RA over innate immune cells, such as macrophages and monocytes, leads to increased production of soluble factors (such as IL-6, IL-10, TNF-α, and IL-1β) [42] and a potential noncanonical presentation of autoantigens.