TNF and Fabry disease: Neuropathic pain pathogenesis involves neuronal dysfunction and neuroinflammation, contributing to the sensitization of sensory neurons.16,54,56 In particular, in FD, microglia are activated by neuronal stress or Gb3 accumulation, undergo morphological changes, and release proinflammatory cytokines (eg, tumor necrosis factor-α [TNF-α], interleukin [IL-1β], IL-6), chemokines, and reactive oxygen species.59 Moreover, lipid accumulation may disturb neuron–glia interactions, exacerbating pain.