Importantly, these immune effects may precede irreversible tissue damage.23 Experimental models confirm early upregulation of TNF-α, IL-1β, and IL-6 before histological fibrosis or necrosis appears.24, –26 Endothelial dysfunction, a hallmark of Fabry disease, is also detected early with oxidative stress and cytokine release even in the absence of significant Gb3 accumulation.27, –29 Our findings align with these data, as patients with low lyso-Gb3 levels still exhibited elevated CRP, ferritin, or complement fractions. The gene discussed is TNF; the disease is Fabry disease.