TNF and chronic obstructive pulmonary disease: One hallmark of COPD is chronic and localized hypoxia, which promotes the release of pro-inflammatory cytokines such as IL-6, TNF-α, and IL-1β (30, 31), thereby triggering systemic inflammation and an “inflammatory storm.” Several LC9 components—such as a healthy diet and optimal glycemic and lipid control—may reduce systemic inflammation by inhibiting oxidative stress and suppressing pro-inflammatory cytokine production (32).