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. Here, TNF is linked to SAPHO syndrome.