TNF and Other metabolic disease: Mechanistically, it was found that sertraline can target several important signaling pathways, such as the TNF-MAP4K4-JNK, a pathway implicated in inflammatory and metabolic disorders and cancer progression, the PI3K/Akt/mTOR, involved in the regulation of cell growth, survival and metabolism, and the AMPK/mTOR, involved in protein synthesis and cell growth regulation.