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Tumor necrosis factor alpha (TNF-alpha) is a cytokine that binds to the TNF-R1 and TNF-R2 receptors. TNF-alpha is mainly secreted by macrophages and induces cell death of certain tumor cell lines. It is a potent pyrogen causing fever by direct action or by stimulation of IL-1 secretion, and therefore found in cachexia accompanying diverse cancers and infections. Genetic variations in TNF are associated with susceptibility to psoriatic arthritis and to HBV infection.