TNF and pulpitis: In recent years, the role of neuroimmune mechanisms in pulpitis has become a focus of the attention of research.6,7 During degranulation, MCs release prestored mediators and a large number of neuropeptides, cytokines, and other substances that include tryptase, tumor necrosis factor-alpha (TNF-α), and nerve growth factor, which affects neuronal function.8,9 Tryptase is a serine protease that is an extremely abundant medium in MCs granules and is the main secreted protein during MC degranulation.