Another critical process during sepsis in which the EVs are also involved is the massive cytokine storm, which refers to multiple activated cascades that lead to an autoamplifying cytokine production, based on a profound increase in pro-inflammatory cytokines such as IL-1, IL-12, IL-18, tumor necrosis factor alpha (TNF-α), chemokines (IL8) and interferons into the circulation causing severe inflammation and tissue damage [29, 30]. This evidence concerns the gene TNF and Sepsis.