TNF and facioscapulohumeral muscular dystrophy: Recent studies have discovered several signaling pathways that are disrupted in FSHD muscle biopsies, including tumor necrosis factor (TNF)-α signaling, hypoxia-inducible factor 1α over-activation, Wnt/β-catenin signaling, and mitochondrial function via oxoglutarate dehydrogenase L [135,144].