TNF and Cowden disease: Reduced expression of immune activation, monocyte, and neutrophil modules in responders at week 14 is consistent with successful drug inhibition of TNF-mediated inflammation, which correlates with reduced neutrophil activation and reduced monocyte recruitment.49 Apoptosis of monocytes induced by anti-TNF in CD patients has also been previously described.44 Certain B cell subsets are reduced in the blood of IBD patients compared to controls,50 so upregulation of B cell modules at week 14 may also represent a shift towards health.