TNF and Menkes disease: Tumor necrosis factor-alpha (TNF-α) inhibitors such as etanercept, interleukin-1 (IL-1) receptor antagonists like anakinra, and monoclonal antibodies directed against B and T cell markers (e.g., rituximab and daclizumab) have demonstrated efficacy in autoimmune inner ear disease (AIED) and hold potential for MD patients with immune-mediated pathology (9, 121–123).