While some authors reported an altered Th1/Th2 balance strongly supported by IL-6, with increased production of Th2 cytokines, such as IL-10 and IL-4 and decreased production of Th1 cytokines, such as IL-2 and IFN-γ (37, 38), others described an elevated Th1/Th2 ratio in MM patients at diagnosis and in refractory phase, pointing towards a close relation to the clinical features (39–41). This evidence concerns the gene IL10 and Miyoshi myopathy.