TNF and neoplasm: The dysfunctional immune system, influenced by a changing gut microbiome, involves elevated myeloid-derived suppressor cells (MDSCs) that deactivate antitumor immune responses, increased expression of pro-inflammatory cytokines (interleukin-1α/β, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNFα), and monocytes and macrophages that promote processes such as angiogenesis, enhancing tumor growth and metastasis, as well as weakened dendritic cell function, which impairs the antitumor T-cell response [92-94].