TNF and gastroesophageal reflux disease: Evidence indicates that esophageal acid exposure is directly associated with the expression of genes for tumor necrosis factor-a, interleukin-10 (IL-10) and interleukin-8 (IL-8).[6] The progression of GERD may enhance the expression of various inflammatory mediators, for instance IL-8, interleukin-6 and IL-10 expressed.[7] However, controversy continues on whether inflammatory cytokines are the cause or a consequence of GERD progression.