On the other hand, the release of TNFα induced by ischemia and reperfusion can also lead to (a) endothelial dysfunction by downregulating mRNA and protein expression of eNOS [26] and (b) increased vascular permeability by promoting interleukin 6 (IL-6) production, inducing dimerization of the endothelial cell (EC) surface receptor GP-130 and disrupting the tight junctions of ECs [27]. Here, IL6 is linked to endothelial dysfunction.