Similar to the pathological process of atherosclerosis (Sluiter et al., 2021), the initiation phase of CAVD involves chemotactic action mediated by cytokines such as TNFα, IL-1β, and IL-6 to activate and recruit immune cells to valve tissue (Isoda et al., 2010; Liu et al., 2017). The gene discussed is TNF; the disease is atherosclerosis.