M1 macrophages enhance inflammatory responses and host defense through the secretion of cytokines such as TNF-α, IL-6, and IL-12, but their excessive activation may lead to tissue damage.[24,25] In contrast, M2 macrophages secrete IL-10 and TGF-β, promoting tissue repair and dampening inflammation.[24] Our analysis revealed a significant increase in M1 macrophages in pediatric septic shock patients, indicating an intensified inflammatory response and compromised tissue repair capacity, which may contribute to organ dysfunction. The gene discussed is TNF; the disease is Shock.