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As the disease progresses, the decrease in cortisol and prolonged exposure to antigens may lead to relative immunodeficiency and depletion of the immune system, which is reflected in an increase in the expression of molecules such as PD-1 and CTLA4 (143)

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These findings seem to be interesting and they seem to indicate that Se also has a dual role in orbital fibroblasts, i.e., under conditions of oxidative stress without cytotoxicity, Se can inhibit the release of pro-inflammatory factors and hyaluronic acid

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