TNF and endothelial dysfunction: Immune complexes are deposited in the vessel wall, triggering a chronic inflammatory response and endothelial disorders.[17] Excessive oxidative stress increases ROS levels, intracellular calcium concentration, ATP consumption, mitochondrial load, and apoptosis.[18] Excessive oxidative stress activates the nuclear factor κ-B (NF-κB) signaling pathway in endothelial cells, which produces a variety of pro-inflammatory factors, such as tumor necrosis factor-α (TNF-α) and matrix metalloproteinases (MMPs), contributing to endothelial dysfunction and lipid plaque formation.[19]