Furthermore, it was demonstrated that DCs derived from both RRMS and SPMS patients have an upregulated expression profile of CD40 but induce different effects, with DCs from RRMS patients inducing higher levels of Th1 (IFN-γ, TNF-α) and Th2 (IL-4, IL-13) cytokines, whereas DCs from SPMS patients only induced a polarized Th1 response [200]. This evidence concerns the gene TNF and secondary progressive multiple sclerosis.