TNF and rheumatoid arthritis: Recent studies have found that abnormal immune responses are closely linked to the pathogenesis of RA, with increased secretion of pro-inflammatory cytokines (e.g., TNF-α, IL-1β, and IL-6 etc.)leads to an imbalance of Treg/Th17 cells (Liu et al., 2023; Bhutta et al., 2024), which exacerbates the development of inflammation; concurrently, these pro-inflammatory cytokines activate a number of pathways involved in bone destruction (Chen Q. Y. et al., 2022), affecting the balance of osteoclasts and osteoblasts, resulting in bone destruction.