TNF and endometriosis: The persistence of activated macrophages in the lesions is maintained by their resistance to apoptosis: in the peritoneal cavity in endometriosis, macrophages demonstrate increased expression of the anti-apoptotic protein Bcl-2, which prevents their death and allows them to serve as a constant source of TNF-α and other cytokines, thereby enhancing disease progression (32, 44, 48).