TNF and Granuloma: Lipopolysaccharide, a component of the outer membrane of Gram-negative bacteria, triggers innate immune responses primarily through Toll-like receptor 4 (TLR-4), leading to the production of inflammatory cytokines such as TNF-α, IL-1, IL-6, and IL-8 in monocytes and macrophages—key mediators involved in granuloma formation in sarcoidosis [13].