As critical effectors and modulators of immune responses, hundreds of cytokines, consisting of interleukins, chemokines and growth factors, have the potential to be involved in TD development, which is favored by the fact that abnormal levels of a few cytokines in the peripheral blood, like TNF-α, IL-12 and IL-1β have been reported in TD patients (8–10), and the knowledge that TS-associated streptococcal infections are certainly able to induce production of various cytokines. This evidence concerns the gene TNF and thanatophoric dysplasia.