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In acid sphingomyelinase knock-out mice, which mimic a neurovisceral acid sphingomyelinase deficiency (ASMD) characterized by cellular accumulation of sphingomyelin, the effects of a choline-free diet decreased the activation of liver macrophages and microglia, but it did not significantly alter sphingomyelin levels due to compensatory mechanisms involving methionine metabolism (101)

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Immune-mediated mechanisms - production of autoantibodies to thyroid antigens and lymphocytic thyroid infiltration - are involved in the pathogenesis of AITD

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