TNF and histiocytic sarcoma: The gut microbiome alterations may increase the production of pro-inflammatory molecules, such as lipopolysaccharide (LPS), peptidoglycan, and flagellin, that can activate the host’s PRRs and induce the secretion of pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin 6 (IL-6), which are elevated in HS patients.