TNF and pulmonary emphysema: TNF-α and IL-1β have been identified as pivotal cytokines with prominent roles in airway remodeling and the development of emphysema, capable of initiating inflammatory cascades during COPD exacerbations (Popa et al., 2007; Rincon and Irvin, 2012; El-Shimy et al., 2014; Farahi et al., 2017; Berry et al., 2022).