Elevated TNF-α production by activated macrophages can potentiate fibroblast differentiation and promote collagen accumulation in myofibroblasts, while increased neutrophil influx mediates chemotaxis of inflammatory macrophages to the site of infection and plays a significant role in inflammation, ARDS, and fibrosis in the lungs (22, 37, 38). Here, TNF is linked to acute respiratory distress syndrome.