TNF and chronic rhinosinusitis: It has been hypothesised that crenotherapy (inhalation treatment with thermal water) with sodium sulphate-chloride water may modulate the expression of pro-inflammatory cytokines and immunoregulatory and antimicrobial peptides such as TNF-α (Tumor Necrosis Factor-α), human β-defensin 2 and calprotectin in the nasal secretions of children with chronic rhinosinusitis.