TNF and chronic obstructive pulmonary disease: Furthermore, SFTOT appears to regulate important signaling pathways such as the Advanced Glycation End-products - Receptor for Advanced Glycation End-products (AGE-RAGE), TNF, PI3K/protein kinase B (Akt) signal transduction pathway (PI3K-Akt), and mitogen-activated protein kinase (MAPK) pathways, which may contribute to its therapeutic effects in COPD.