Although we did not find a specific effect of Healthycell on TNF-α, a pro-inflammatory cytokine known to be related to many diseases including rheumatoid arthritis, inflammatory bowel disease, psoriasis, psoriatic arthritis, and ankylosing spondylitis [40-42], we noted positive effects on sTNFR-I/-II. Here, TNF is linked to ankylosing spondylitis.