TNF and irritable bowel syndrome: This shift in the microbial composition might be associated with various aspects of IBS pathophysiology, including microinflammation of the colonic mucosa, increased levels of proteases and pro-inflammatory markers such as interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), and decreased levels of interleukin-10 (IL-10) [69].