NELFCD and ulcer disease: However, several data indicate that an exaggerated and unbalanced Th1 response may lead to intense tissue damage and more severe clinical forms of the disease.5, 6 In fact, it has been demonstrated that the ulcer size was positively correlated with circulating Th1 cytokines (IFN-γ and TNF-α) and activated T cells, which corroborates with this assumption.7