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Additionally, environmental factors such as iodine excess or deficiency, smoking, stress, exposure to chemicals, medications (e.g., amiodarone, interferon-), and some viral/bacterial infections can alter gene expression patterns through epigenetic mechanisms and trigger autoimmune processes

Stratifications based on the three factors showed different between-study heterogeneities for several subgroups (eFig

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Visits 6 and 7 for follow-up assessment at week 12 were conducted as indicated for baseline visits 3 and 4