Accumulating evidence supports the link between the pro-inflammatory cytokine profile in peripheral blood mononuclear cells and the pathogenesis of MD, including higher basal levels of IL-1β, IL-6 and TNF-α and a release of TNF-α induced by both Aspergillus and Penicillium extracts in several patients with uni- or bilateral MD (35). This evidence concerns the gene IL6 and Menkes disease.