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  • There is evidence for immune-mediated pathology in which pro-inflammatory cytokines such tumor-necrosis factor-?? (TNF-??) provoke and sustain neuropathic pain.19-21 Oxidative stress has also been implicated in the pathogenesis of small fiber neuropathy.22-24 Nutritional deficits, alcohol, smoking and toxins, such as mercury, arsenic, and lead, can all contribute.
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  • podiatrytoday.com