TNF and chronic rhinosinusitis: Systemic inflammation, exemplified by gut dysbiosis, abdominal fat tissue, silicone breast implants, chronic sinusitis, and psychological stress, is associated with elevated levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and transforming growth factor-beta (TGF-β) [26,27,28,29,30,31].