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The consequence of this interaction is the breakdown of immune tolerance, manifested by the proliferation of follicular helper T (Tfh) and Th17 cells, impaired function of Tregs, aberrant B-cell activation leading to excessive autoantibody production, elevated levels of inflammatory mediators, multiorgan inflammation, and tissue damage, ultimately culminating in the development of autoimmune disorders

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In this context, ROS can directly oxidize the hydroxyl group of carnitine, impairing its biological activity