TNF and juvenile idiopathic arthritis: The biological foundation of central sensitization is rooted in the profound dysregulation of the Neuro-Immune Axis, within which microglia—the resident immune cells of the central nervous system—play a critical role (6) In the pathogenesis of JIA, inflammatory cytokines released from the peripheral joints, such as Tumor Necrosis Factor-alpha (TNF-α) and Interleukin-1beta (IL-1β), can transmit “alarm” signals to the central nervous system via humoral or neural pathways (7, 8).