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Proinflammatory cytokines alter the expression of immune-related molecules on the surface of thyroid cells, such as the upregulation of major histocompatibility complex (MHC) molecules, making thyroid cells more likely to be recognized by the immune system and attacked by immune cells (Yan et al., 2024)

Variability is common and often reflects neuroimmune and autonomic dysregulation rather than inconsistency or psychological causes

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