TNF and inflammatory response: Severe pulmonary inflammation is accompanied by elevated proinflammatory cytokines in serum [especially interleukin-6 (IL-6), IL-8, and tumor necrosis factor-alpha (TNF-α)] (7) and bronchioalveolar lavage (especially CXCL1, CXCL2, and CXCL6) (8), resulting in neutrophil infiltration and activation in lungs (9), consistent with development of acute respiratory distress syndrome (ARDS).