Whilst, among individuals with latent RHD, interleukins (IL-4, IL-8 and IL-1RA) seem to predict clinical disease, in patients with established RHD the co-regulated expression of IL-6 and TNF-α is associated with severe valve dysfunction, and high IL-10 and IL-4 levels predict adverse outcomes [25]. The gene discussed is IL4; the disease is rheumatic heart disease.