“…6 These changes are consistent with release of pro-inflammatory cytokines such as IL-1, IL-6, TNF and interferon-␥. [6][7][8] Indeed, elevated levels of TNF␣, interferon-␥, IL-2, IL-4 and IL-5 have been detected in ulcer tissue 7,8 and raised levels of IL-6 in the circulation. 9 It has been suggested that RAS is precipitated by local trauma in an individual genetically predisposed to an exaggerated or abnormal cytokine cascade.…”