TNF and arteriosclerosis: Studies have shown that VOCs activate the immune system by stimulating T-cells to release inflammatory mediators, such as tumor necrosis factor-alpha (TNF-α) and interleukins-4 (IL-4) and interleukins-13 (IL-13), damaging endothelial cells and impairing vascular function, which increases the risk of arteriosclerosis (50).