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Tumor necrosis factor (TNF)-alpha is expressed primarily by activated monocytes as part of the innate immune response to various microbes, gram-negative bacteria in particular. It’s function is to recruit other leukocytes to the site of infection and to stimulate their activation. TNF-alpha also has some systemic effects, including induction of fever through action on the hypothalamus. In cases of severe gram-negative bacterial infection, Septic shock can occur characterized by hypotension, disseminated intravascular coagulation, tachycardia & increased respiration and can be fatal. Dysregulation of TNF-alpha expression is thought to be a critical pathogenic mechanism in numerous autoimmune diseases, including Inflammatory bowel disease (IBD), Rheumatoid arthritis (RA) and Ankylosing spondylitis (AS). TNF-alpha is used for the evaluation of patients with suspected systemic infection, particularly caused by gram-negative bacteria & for the evaluation of patients with suspected chronic inflammatory disorders.