TNF-alpha and and IL-6 are just two parts of the immune cascade that always takes place during the immune response to trauma; which always follows every injury, no matter how minor.

This, and everything else in the immune response, are greatly increased in ischemua-reperfusion injury (IRI), which I have been saying for six years is what RSD really is. This is because IRI involves an immune response that doesn't end as is's supposed to: It continues and expands into an ever-widening area which sometimes doesn't end until an entire limb or organ are affected.

This abnormally widening immune response involves red, warm, swollen skin (inflammation) that often feels much like a sunburn. Inflammation is caused by oxygen free radicals (OFRs), which are the chemicals our white blood cells use to destroy invading pathogens. They also damage and destroy healthy cells.

IRI doesn't end with inflammation, however; it ends when white blood cells plug capillaries, permanently blocking them. Blood will never flow through these capillaries again. The cyanotic skin color we see in RSD is oxygen-depleted blood in blocked capillaries.

Our findings confirm the presence of local inflammation in a population of 66 patients in the first 2 years of CRPS1. Proinflammatory cytokines seem to be only partly involved in the pathophysiology of CRPS1, as indicated by the lack of coherence between TNF-alpha and IL-6 levels and the signs and symptoms of inflammation and disease duration.

The reason these signs of inflammation subside is that the immune response ends at some point, and is followed by the 2nd stage: Blocked capillaries, colder skin temperatures, and cyanosis. RSD and IRI only begin with inflammation; it doesn't last throughout the disease.

You can, if you wish, dismiss what I just wrote because I'm not a professional scientist, but you don't need to be a scientist to read science. All you need to do read about the IRI process for yourself. You will find it is exactly as I just described it.

The reason RSD and IRI haven't been linked is that that both are rare disorders, and specialists who are familiar with one of them never hear of the other.

Today, IRI is only believed to occur following trauma from surgery, and only thoracic surgeons deal with it: They never see RSD patients, and if they hear of the disease and look into it, they never read the word cynaosis in RSD literature. If they knew of a disorder that began with trauma and inflammation that turned into cyanosis, I think they would be interested.

I learned about IRI after I couldn't find any explanation for -- or even the word -- cyanosis in the RSD literature, so I began researching diseases in which cyanosis is evident: I found IRI, researched it, and learned that it explains every sign and symptom of RSD. You can do the same thing. If you do, you have taken the first step toward finding remission from this disease and return to a more normal, and pain-free life,

It really is your choice: You can spend some time studying for yourself, or you can wait, and suffer, and hope the experts will finally stop blaming nerve damage and begin looking for the real cause. They won't have to look far...Vic