Abstracts tagged "Rheumatoid Factor"

Abstract Number: 2248 • ACR Convergence 2025
Elevated Anti-PAD Autoantibodies in a Singaporean Chinese Rheumatoid Arthritis (RA) Cohort with Rheumatoid Factor (RF) and Anti-Citrullinated Protein Antibodies (ACPA) Positivity: A Case-control Exploratory Study
Margaret Ma¹, Khai Pang Leong², ee tzun koh², Preeti Dhanasekaran³, janique peyper⁴, bermet abylova⁴, Anselm Mak³ and Peter Cheung¹, ¹National University Hospital, Singapore, Singapore, ²Tan Tock Seng Hospital, Singapore, Singapore, ³National University of Singapore, Singapore, Singapore, ⁴Standard BioTools, Singapore, Singapore
Background/Purpose: Autoantibody-based biomarkers including ACPA and RF are of established clinical use in rheumatoid arthritis (RA) and are ingrained in international classification criteria. However, other…
Abstract Number: 2231 • ACR Convergence 2025
Inverse Correlation Between Neutrophil Activation and Rheumatoid Factor Concentrations in Rheumatoid Arthritis (RA)
Anne-Christine Bay-Jensen¹, Dovile Sinkeviciute², Christian Thudium², shu Sun¹, Mathilde Christensen¹, Morten Karsdal¹, marta Alexdottir¹ and Joachim mortensen¹, ¹Nordic Bioscience A/S, Herlev, Denmark, ²Nordic Bioscience, Herlev, Denmark
Background/Purpose: Neutrophils are crucial in fibro-inflammatory diseases like Crohn's disease (CD) and rheumatoid arthritis (RA), but their biomarkers are better established in CD than in…
Abstract Number: 1692 • ACR Convergence 2025
Rheumatoid factor is associated with increased gut permeability and migration of B cells to the joint via CXCR3 in rheumatoid arthritis
Ken Yasaka¹, Nida Pellett², Daria Krenitsky¹ and Jennifer Anolik², ¹University of Rochester, Rochester, NY, ²University of Rochester Medical center, Rochester, NY
Background/Purpose: It has been proposed that the mucosal environment is associated with the pathogenesis of rheumatoid arthritis (RA). In addition to gut dysbiosis, intestinal barrier…
Abstract Number: 1366 • ACR Convergence 2025
Cost Per Responder Analysis of Certolizumab Pegol Versus Adalimumab in Patients with Moderate to Severe Active Rheumatoid Arthritis and High Rheumatoid Factor Levels: A Payer Perspective from Canada and Brazil
Rémi Marty¹, Baran Ufuktepe², Nicola Tilt³, Flore Decuypere⁴, Angela Blake³, Sandeep Kiri³ and Mohammed Soomro³, ¹UCB Pharma, Brussels, Belgium, Anderlecht, Belgium, ²UCB Pharma Istanbul, Turkey, istanbul, Turkey, ³UCB Pharma, Slough, United Kingdom, Slough, United Kingdom, ⁴UCB Pharma Brussels, Belgium, Brussels, Belgium
Background/Purpose: According to the 2022 EULAR recommendations for the management of rheumatoid arthritis (RA), the presence of rheumatoid factor (RF), particularly at high levels, is…
Abstract Number: 1322 • ACR Convergence 2025
High Rheumatoid Factor Titers and Biologic Persistence in RA: Beyond TNF Inhibitors
Sara Salas Santamaría¹, Marta Chao Moreira², Manuel Juárez³, Marta Novella-Navarro², Pilar Nozal², Ana Martínez², Carolina Tornero⁴, Cristina Bohorquez⁵, Ana Sánchez², Carmen Cámara², Eduardo López², Eugenio de Miguel² and Chamaida Plasencia-Rodríguez², ¹Hospital Universitario La Paz, Miranda de Ebro, Castilla y Leon, Spain, ²Hospital Universitario La Paz, Madrid, Spain, ³Rheumatology Unit, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain, ⁴Hospital La Paz, Madrid, Spain, ⁵La Paz University Hospital, Alcalá De Henares, Spain
Background/Purpose: Rheumatoid factor (RF), an autoantibody targeting the Fc portion of IgG, is one of the most studied biomarkers in rheumatoid arthritis (RA). High RF…
Abstract Number: 1317 • ACR Convergence 2025
The Association Between Insomnia and Rheumatoid Arthritis: A Systematic Review and Meta-Analysis of 546,822 Patients
Mohamed Abdelsalam¹, Maryam Lasheen², Menat Alla Ayman Ali Mahdy³, Hadeer Hafez⁴, Nourhan Abouelella⁵, Mohamed Al-Adl⁶ and Mohamed Reda Awad⁷, ¹Misr University For Science and Technology, ⁶ october, Al Jizah, Egypt, ²Misr University For Science and Technology, Helwan, Al Qahirah, Egypt, ³Misr University For Science and Technology, Nasr City, Al Qahirah, Egypt, ⁴⁶th October University, ⁶ october, Al Jizah, Egypt, ⁵Faculty of Medicine, Misr University for Science and Technology, ⁶ october, Al Jizah, Egypt, ⁶Faculty of medicine Al-Azhar University Cairo, Nasr City, Egypt, ⁷Al Azhar University, Cairo, Egypt, Giza, Al Jizah, Egypt
Background/Purpose: Insomnia and rheumatoid arthritis (RA) are caught in a snowball effect, where chronic pain disrupts sleep and causes poor sleep quality, which in turn…
Abstract Number: 0689 • ACR Convergence 2025
Development of an Articular Activity Score in Systemic Sclerosis (ASSESS): Identifying Core Instruments for Disease Activity Assessment
Blaz Burja¹, Paco Welsing², Alain Lescoat³, Andreas Eisenring⁴, Anna-Maria Hoffmann-Vold⁵, Claire Leroy David⁶, Dinesh Khanna⁷, Francesco Del Galdo⁸, Michele Iudici⁹, Janet Pope¹⁰, julia Spierings¹¹, Madelon Vonk¹², Marie-Elise Truchetet¹³, Martine Clergeau¹⁴, Michael Hughes¹⁵, Susan Murphy¹⁶, Tracy Frech¹⁷, Oliver Distler¹⁸ and Muriel Elhai¹⁹, ¹Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland, Zurich, Switzerland, ²Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands, Utrecht, Netherlands, ³CHU Rennes - University Rennes, Rennes, France, ⁴Patient research partners, Zurich, Switzerland, ⁵Oslo University Hospital, Oslo, Norway, ⁶Patient research partners, Sos, France, ⁷University of Michigan, Ann Arbor, MI, ⁸University of Leeds, Leeds, United Kingdom, ⁹Division of Rheumatology, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland, Geneva, ¹⁰University of Western Ontario, London, ON, Canada, ¹¹Department of Rheumatology & Clinical Immunology, University Medical Center, Ultrecht, The Netherlands, Utrecht, Netherlands, ¹²Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands, ¹³Bordeaux University Hospital, Bordeaux, France, ¹⁴Patient research partners, Paris, France, ¹⁵Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK, Manchester, England, United Kingdom, ¹⁶Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA, Michigan, ¹⁷Vanderbilt University Medical Center, Nashville, TN, ¹⁸Department of Rheumatology, University Hospital Zurich, University of Zurich, Switzerland, Zurich, Switzerland, ¹⁹Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich, Zurich, Switzerland, Schlieren, Switzerland
Background/Purpose: Inflammatory joint and/or tendon involvement affects up to 30% of patients with systemic sclerosis (SSc), resulting in pain, reduced joint function, and impaired patients'…
Abstract Number: 0496 • ACR Convergence 2025
Certolizumab Pegol Shows a Higher Retention Rate Compared to JAK Inhibitors in Patients with Rheumatoid Arthritis, Regardless of Baseline Rheumatoid Factor Levels. A Multicenter Retrospective Study.
Mitndbaim Parra¹, Rafaela Ortega-Castro², Jerusalén Calvo³, Francisco Jose Cepas⁴, Montserrat Robustillo-Villarino⁵, Andres Zuniga-Vera⁵, Ana Martinez-Feito⁶, Chamaida Plasencia-Rodríguez⁷, Ester Costa-Moya⁸, Delia Taverner-Torrent⁸, Luis Sainz Comas⁹, Cesar Diaz-Torne⁹, Virginia Ruiz-Esquide¹⁰, Cynthia Rojas¹¹, Lourdes Martin-de la Sierra Lopez¹², Laura Jimenez-Rodriguez¹², David Velasco-Sanchez¹², Regina Fará Garcia¹³, Antonio Juan-Mas¹⁴, Marina soledad Moreno Garcia¹⁵, Ana Valeria Acosta Alfaro¹⁶, Santiago Muñoz¹⁷, Maria Martín López¹⁸, Raquel Zas¹⁹, FRANCISCO JAVIER GODOY NAVARRETE²⁰, Isabel Anon Onate²¹, Fernando Ortiz-Márquez²², Natalia Mena Vázquez²³, Paula Estrada-Alarcón²⁴, Lourdes Ladehesa²⁵, Alejandro Escudero Contreras³ and Clementina López Medina²⁶, ¹¹. Rheumatology Department, Reina Sofía University Hospital, Cordoba/IMIBIC/University of Cordoba., Cordoba, Spain, ²Rheumatology service/Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/ Reina Sofia University Hospital/ University of Cordoba, Spain, Cordoba, Andalucia, Spain, ³IMIBIC / Reina Sofia Hospital / University of Cordoba, Córdoba, Spain, ⁴University of Cordoba, Cordoba, Spain, ⁵Department of Rheumatology, Hospital Universitario de la Plana, Vila-real, Castellón, Spain, Vila-real, Castellón, Spain, ⁶Hospital Universitario La Paz, Madrid, Madrid, Spain, ⁷Hospital Universitario La Paz, MADRID, Spain, ⁸Hospital Sant Joan Reus, Reus, Spain, ⁹Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, ¹⁰Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain, ¹¹Hospital Clinic, Barcelona, Spain, ¹²Hospital General Universitario de Ciudad Real, Ciudad Real, Spain, ¹³Hospital Son Llàtzer, Palma, Spain, ¹⁴Son Llazter University Hospital, Madrid, Spain, ¹⁵Hospital Universitario Miguel Servet, Zaragoza, Spain, ¹⁶Hospital Universitario Infanta Sofia; Universidad Europea de Madrid; FIIB HUIS-HUHEN, Madrid, Spain, ¹⁷Hospital Universitario Infanta Sofía;Universidad Europea de Madrid. Faculty of Medicine, Health and Sports. Department of Medicine; FIIB HUIS-HUHEN, Madrid, Spain, ¹⁸Hospital ¹² de Octubre, Madrid, Spain, ¹⁹Hospital Universitario Doce de Octubre, Madrid, Spain, ²⁰Jaen University Hospital, Spain, Jaen, Spain, ²¹Hospital Universitario de Jaén, Jaén, Spain, ²²Department of Rheumatology, Hospital Regional Universitario de Málaga, Málaga, Spain, Malaga, Spain, ²³Hospital Regional Universitario de Malaga, Malaga, Spain, Málaga, Spain, ²⁴Hospital de San Juan Despí Moisès Broggi, Barcelona, Spain, ²⁵IMIBIC-Reina Sofia Hospital-University of Cordoba, Cordoba, Spain, Cordoba, Spain, ²⁶Department of Medicine, Hospital Universitario Reina Sofia, University of Cordoba, IMIBIC, Cordoba, Spain
Background/Purpose: Rheumatoid factor (RF) is an antibody directed against the Fc fragment of IgG that plays a key role in the development of rheumatoid arthritis…
Abstract Number: 0471 • ACR Convergence 2025
An Open-label, Randomized, Controlled Phase 1/2 Study to Assess the Safety and Efficacy of KYV-101 Anti-CD19 CAR-T Cell Therapy in Active and Difficult-to-treat ACPA positive Rheumatoid Arthritis: Preliminary Results of the COMPARE Trial
Fredrik Albach¹, Ioanna Minopoulou¹, Artur Wilhelm², Robert Biesen¹, Arnd Kleyer¹, Norman Drzeniek³, Edgar Wiebe⁴, Anja Fleischmann³, Dominic Borie⁵, Vincent Casteleyn³, Tobias Alexander³, Christian Furth⁶, Jan Zernicke³, Burkhard Muche⁷, Sandra Hermann⁴, Pfeil Alexander⁸, Veronika Scholz³, Elpida Phithak³, Olaf Penack⁹, Kamran Movassaghi⁹, Eva Vanessa Schrezenmeier¹⁰, Udo Schneider³, Antonia Busse¹¹, Georg Schett¹², Ulrich Keller¹¹, Lars Bullinger⁹, Gerhard Krönke¹³, Marie Luise Hütter-Krönke¹⁴ and David Simon¹⁵, ¹Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany, Berlin, Germany, ²Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Germany, Berlin, ³Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany, Berlin, ⁴Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany, Berlin, Berlin, Germany, ⁵Kyverna Therapeutics, Emeryville, CA, ⁶Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany, Berlin, ⁷Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany, ⁸Department of Internal Medicine III, Jena University Hospital - Friedrich Schiller University Jena, Jena, Germany, ⁹Department of Hematology, Oncology and Tumor Immunology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany, Berlin, ¹⁰Department of Nephrology, Charité - Universitätsmedizin Berlin, Berlin, Germany, Berlin, ¹¹Department of Hematology, Oncology and Cancer Immunology, Charité - Universitätsmedizin Berlin, Campus Steglitz, Berlin, Germany; Max-Delbrück-Center for Molecular Medicine, Berlin, Germany; German Cancer Consortium (DKTK) partner site Charité Berlin and German Cancer Research Center (DKFZ), Heidelberg, Germany, Berlin, ¹²Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany, Erlangen, Germany, ¹³Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Germany, Berlin, Berlin, Germany, ¹⁴Department of Hematology, Oncology and Cancer Immunology, Charité - Universitätsmedizin Berlin, Campus Steglitz, Berlin, Germany, Berlin, ¹⁵Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Germany, Berlin, Germany
Background/Purpose: Rheumatoid Arthritis (RA) is a chronic autoimmune disease characterized by autoreactive B cells that produce anti-citrullinated protein antibodies (ACPA), contributing to sustained synovial inflammation…
Abstract Number: 0441 • ACR Convergence 2025
Charting the Course of Worsening: Utilizing Standard Outcomes to Define Worsening for Pathophysiological Insights into RA
Charis Meng¹, Caci Julia², Kelsey Gripp², Deanna Jannat-Khah¹, Yvonne Lee³, Susan J. Bartlett⁴, Clifton Bingham⁵ and Vivian Bykerk¹, ¹Hospital for Special Surgery, New York, NY, ²Hospital for Special Surgery, New York, ³Northwestern University, Chicago, IL, ⁴McGill University, Beaconsfield, QC, Canada, ⁵Johns Hopkins University, Baltimore, MD
Background/Purpose: RA disease worsening contributes to joint damage and cardiovascular disease. While measures of improvement are established in RA, we do not have uniform definitions…
Abstract Number: 0435 • ACR Convergence 2025
Comparative Outcomes in Seropositive and Seronegative Rheumatoid Arthritis: A Retrospective Cohort Study
Ahmad Alomari¹, Reem Elmusa², Nikita Shah³, Miguel Rodriguez⁴ and Diala Alawneh⁵, ¹UCF- North Florida hospital, Gainesville, FL, ²UCF/ HCA - North florida hospital, Gainesville, FL, ³UCF/HCA Florida North Florida Hospital, Gainesville, FL, ⁴SIMED Rheumatology, Gainesville, FL, ⁵University of Florida, Gainesville, FL
Background/Purpose: Rheumatoid arthritis (RA) is a chronic autoimmune disease that manifests as either seropositive or seronegative subtypes. Seropositive RA, characterized by the presence of autoantibodies…
Abstract Number: 0430 • ACR Convergence 2025
Retrospective evaluation of the clinical impact of democgraphic , serological , clinical , radiological parameters and treatment modalities in patients with RA-ILD
fatih ŞAhiner¹, Mine Nokay², funda erbasan², Veli Yazisiz³ and Ender terzioglu², ¹Akdeniz University, Antalya, ²Akdeniz University, Antalya, Turkey, ³Akdeniz University, Faculty of Medicine, Antalya, Turkey
Background/Purpose: RA-ILD is significant determinants of morbidity and mortality. This study aims to evaluate the demographic and serological characteristics of RA-ILD patients and investigate the…
Abstract Number: 2279 • ACR Convergence 2025
Long-Term Prevention of RA in high-risk individuals after a 6-Month Placebo-Controlled Intervention with Abatacept -The ARIAA Trial
Koray Tascilar¹, Mikkel Ostergaard², Verena Schoenau³, Uta Kiltz⁴, Xenofon Baraliakos⁴, David Kofler⁵, Martin Feuchtenberger⁶, Ulrike Steffen⁷, Mario Zaiss⁸, Michael Zaenker⁹, Reinhard Voll¹⁰, Cornelia. Glaser¹¹, Holger Bang¹², Eugen feist¹³, Gerd Burmester¹⁴, Kirsten Karberg¹⁵, Joachim Strunk¹⁶, Juan Cañete¹⁷, Esperanza Naredo¹⁸, Mária Filková¹⁹, Ladislav Šenolt¹⁹, Georg Schett²⁰ and Juergen Rech⁷, ¹Department of Medicine ³ - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany, ²Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark, and Copenhagen Center for Arthritis Research, Center for Rheumatology, Rigshospitalet, Glostrup, Denmark, ³- Department of Medicine ³ - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Uniklinikum Erlangen, Erlangen, Germany., Erlangen, Germany, ⁴Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany, ⁵University of Cologne, Cologne, Germany, ⁶MED | BAYERN OST GmbH, Fachbereich Rheumatologie, Burghausen, Germany, Burghausen, Bayern, Germany, ⁷Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Department of Internal Medicine ³ - Rheumatology and Immunology, Erlangen, Germany, Erlangen, Bayern, Germany, ⁸¹Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Department of Internal Medicine ³ - Rheumatology and Immunology, Erlangen, Germany, Erlangen, Bayern, Germany, ⁹Immanuel Klinikum Bernau , Herzzentrum Brandenburg, Abteilung Innere Medizin, Bernau, Germany, Berlin, Germany, ¹⁰University Medical Center Freiburg, Freiburg, Germany, ¹¹Department of Rheumatology and Clinical Immunology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany, Freiburg, Baden-Wurttemberg, Germany, ¹²Orgentec, Mainz, Germany, ¹³Helios Department of Rheumatology, Vogelsang-Gommern, Germany, ¹⁴Department of Rheumatology and Clinical Immunology, Charité – Universitätsmedizin Berlin, Berlin, Germany, ¹⁵Praxis für Rheumatologie und Innere Medizin, Rheumatologie, Berlin, Germany, Berlin, Germany, ¹⁶Krankenhaus Porz am Rhein GmbH, Rheumaklinik, Köln (Porz), Germany, Köln-Porz, Germany, ¹⁷Rheumatology Department, Hospital Clínic and IDIBAPS, Barcelona, Spain, Barcelona, Spain, ¹⁸Department of Rheumatology and Joint and Bone Research Unit. Fundación Jiménez Díaz University Hospital and Health Research Institute FJD-UAM, Madrid, Spain, MADRID, Spain, ¹⁹Institute of Rheumatology and Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic, ²⁰Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany, Erlangen, Germany
Background/Purpose: A 6-month intervention with abatacept in the ARIAA trial (EUDRA-CT 2014–000555–93) significantly retarded the development of RA compared to placebo in ACPA-positive individuals with…
Abstract Number: 0155 • ACR Convergence 2025
Effect Modification of Cigarette Smoking on the Relationship between Post Traumatic Stress Disorder and Rheumatoid Arthritis Risk
Kelsey Coziahr¹, Harlan Sayles¹, Tate Johnson¹, Joshua Baker², Punyasha Roul³, Grant Cannon⁴, Gary Kunkel⁵, Bryant England¹ and Ted Mikuls¹, ¹University of Nebraska Medical Center, Omaha, NE, ²University of Pennsylvania, Philadelphia, PA, ³UNMC, Omaha, NE, ⁴University of Utah and Salt Lake City VA, Salt Lake City, UT, ⁵Salt Lake City VA, Salt Lake City, UT
Background/Purpose: Post-traumatic stress disorder (PTSD) is associated with increased systemic inflammation that may increase the risk of developing autoimmune disorders such as rheumatoid arthritis (RA).…
Abstract Number: 2274 • ACR Convergence 2025
Importance Of Fc Region On Therapeutic Survival In Rheumatoid Arthritis Patients With Anti-TNF Therapy
ELENA GRAU GARCIA¹, Iago Alcántara Álvarez², Jose Ivorra Cortes³, Pablo Muñoz Martinez⁴, Laura Mas Sanchez⁵, Alba Maria Torrat Noves⁶, Daniel Ramos Castro⁷, Belen Villanueva Manes⁸, Miguel Simeo Vinaixa⁴, Andres Perez Hurtado⁹ and José Andrés Román Ivorra¹⁰, ¹HUP La Fe, Valencia, Comunidad Valenciana, Spain, ²Hospital Universitari i Politénic La Fe, València, Spain, ³Hospital Universitario La Fe, Valencia, Comunidad Valenciana, Spain, ⁴Rheumatology Department. HUP La Fe, Valencia, Spain, ⁵Hospital Universitari i Politecnic La Fe, València, Spain, ⁶Hospital Universitari i Politècnic La Fe de Valencia, Valencia, Spain, ⁷Hospital Universitari i Politecnic La Fe, Valencia, Spain, ⁸Hospital La Fe, València, Spain, ⁹Hospital Universitario y Politècnico La Fe, València, Comunidad Valenciana, Spain, ¹⁰Hospital Universitari i Politècnic La Fe, Valencia, Spain
Background/Purpose: In patients affected by rheumatoid arthritis (RA), it has been studied a relation between high rheumatoid factor (RF) and a favorable response to anti-TNF…

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