TNF and lymphedema: In lymphedema, internally persistent deterioration spontaneously progresses in affected soft tissues, starting first at the molecular level mediated by the increased release of proinflammatory cytokines (interleukin [IL]-6, IL-8, tumor necrosis factor [TNF]-α, transforming growth factor [TGF]-β1) and leading to macroscopic fibrosis consisting of collagen and extracellular matrix deposition10,11.