This imbalance is caused by the dysregulation of several cytokines, chemokines, growth factors, and other components secreted by bone marrow stromal cells (BMSCs), which contribute to a symbiotic cycle that maintains an MM-promoting microenvironment and allows the tumor cells to secrete interleukin-1β (IL-1β), tumor necrosis factor alpha (TNF-α), transforming growth factor β (TGF-β), VEGF, and interleukin-6 (IL-6).6 This evidence concerns the gene TNF and Miyoshi myopathy.