In HIE, serum inflammatory markers such as interleukin-6 (IL-6), IL-8, tumor necrosis factor-alpha (TNFα), interleukin-1-beta (IL-1β), and IL-1 receptor antagonist (IL-1RA) have been associated with encephalopathy severity, seizure burden, and abnormal MRI findings.124–126 Among emerging candidates, inter-alpha inhibitor proteins (IAIPs)—liver-derived protease inhibitors involved in immune modulation and vascular integrity—have shown particular promise. This evidence concerns the gene TNF and Encephalopathy.