TNF and periodontal disorder: Here, periodontal bacteria, including Porphyromonas gingivalis and Campylobacter rectus, have been found in the amniotic fluid of expectant mothers who have periodontal disease.7,10,12 The indirect pathway is mediated via inflammatory mediators, namely interleukins such as IL-1, IL-6, IL-8, TNF-α and prostaglandins like PGE2 from periodontal sites, triggering a host immune response.