In addition, in accordance with the severity of the hyperplasic gastric mucosa of eight PDP patients, IL-6, TNFα and RANKL expression were strongest in serious hypertrophic gastric mucosa (Fig. 3 P1 a e i), then gradually reduced in moderately (Fig. 3 P4 b f j) and mildly (Fig. 3 P6 c g k) thickened gastric mucosa. This evidence concerns the gene TNF and primary hypertrophic osteoarthropathy.