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Based on existing knowledge, we cannot determine which factor is of utmost importance and what are the underlying mechanisms

Immune dysregulationparticularly involving T-helper cell imbalance, increased pro-inflammatory cytokines (e.g., TNF-, IL-6), and reduced regulatory T cell functionhas been shown to impair maternal-fetal tolerance

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Mizrahi, M., Adar, T., Lalazar, G., Nachman, D., El Haj, M., Yaacov, A