TNF and infection: This appears counterintuitive given the pro-inflammatory nature of these cytokines but is a hallmark of the immunosuppressive phase of sepsis, which is increasingly recognized as a critical driver of secondary infections and organ dysfunction.[16,35,36] Lower levels of IFN-γ and TNF-α may signify a state of immune exhaustion, where the innate and adaptive immune systems are unable to mount an effective response.