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These include:[ref] Inflammatory cytokines (IL-1B, IL-33), which cause the release of IL-6, TNF, IL-8, and VEGF Heavy metals (aluminum, cadmium, mercury) Herbicides (atrazine, glyphosate) Pathogens (Lyme disease, lipopolysaccharides from bacteria, certain viruses, and mold spores) These triggers can cause a two-phase reaction : Immediately released mediators include histamine, TNF, tryptase, RANKL, and serotonin