TNF and septic shock: For example, endotoxin may trigger cellular biosynthesis, activate intracellular mechanisms of apoptosis, and induce strong activation of inflammatory pathways with the consequent release of pro-inflammatory cytokines and chemokines, such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and interleukin-18 (IL-18), and other bioactive metabolites of organ damage and septic shock [3,22,23].