IL23R and SAPHO syndrome: Studies showed that the Th1 cell cytokines including interleukin (IL)-6 and TNF-α were evaluated both in the salivary of patients with primary SS and in the serum of patients with SAPHO syndrome.[17,18] For the IL-23-IL23R-Th17-IL17 axis, Th17 cells were reported being increased in the peripheral blood in patients with SAPHO syndrome and in the salivary gland biopsy in patients with primary SS.