TNF and endothelial dysfunction: Among the multiple upstream insults capable of initiating endothelial dysfunction, the cytokine storm—a hyperinflammatory state marked by excessive production of proinflammatory cytokines such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interleukin-1 beta (IL-1β)—has emerged as a key driver.