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4 The Case 1 patient had hyperpigmentation over the dorsum of all the toes, similar to the type of pigmentation described by Baker et al

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The activation of TLR4 triggers two signaling pathways: the first one involving TIRAP and MyD88 adaptor proteins begins in the plasma membrane, while the second, depending on TRAM and TRIF, is induced in early endosomes after endocytosis of the receptor governed by a GPI-anchored protein, CD14 [23]