TNF and periodontitis: For example, sEVs from apical papilla stem cells (SCAP-sEVs) can suppress pro-inflammatory cytokines [e.g., tumor necrosis factor α (TNF-α)] while decreasing the distance between the cementoenamel junction and alveolar bone crest (CEJ-ABC, a key indicator of clinical attachment loss) in a mouse periodontitis model[18].