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TNF- also rapidly stimulates MAPKs, encompassing p38 MaPK, extracellular signal-regulated kinases 1 and 2, and c-Jun N-terminal kinases in differentiated myotubes, resulting in enhanced expression of the atrogin-1 /muscle atrophy F-box protein (MAFbx) gene in skeletal muscle [156]

These DAMPs further activate immune cells, exacerbating the inflammatory response [149, 188]

The paper reports the absence of the positive effect under twice-daily dosing rather than a measured decrement, and no head-to-head statistical comparison of the two schedules is given but even read at its most conservative, that is not how a dose-dependent hypnotic behaves