TNF-α also inhibited the differentiation of osteoblasts through nuclear factor kappa-B and mitogen-activated protein kinase pathways [19]. TB, a chronic infection, usually has a higher inflammatory burden. TB induced the host’s body to release inflammatory cytokines such as TNF-α and IL-1 [20]. Therefore, these inflammatory cytokines in patients with TB lead to increased osteoclastogenesis and diminished osteoblastic activity, resulting in accelerated bone resorption and osteoporosis. Here, TNF is linked to osteoporosis.