TNF and periodontal disorder: Both the IL-6 family and TNF have pleiotropic effects on lymphocyte promotion and tissue destruction and are recognized as pro-inflammatory cytokines.33 IL-8 and its polymorphisms are associated with an increased risk of periodontal disease.34 The presence of bacterial metabolic products and other substances (lipopolysaccharides, enzymes, and toxins) enhances proinflammatory cytokine expression and the release of active agents, promoting local tissue-lesion development.35