TNF and Cirrhosis: In advanced cirrhosis, bacterial translocation further activates the immune system, leading to an increase in levels of pro-inflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, and interferon-γ, and a decrease in levels of anti-inflammatory cytokines such as IL-10 and transforming growth factor-β [28].