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The subsequent antigen presentation triggers the activation of Th1 and Th17 cells, leading to the release of pro-inflammatory cytokines (IL-2, TNF-, IFN-, IL-17), which in turn amplify oxidative stress and perpetuate an amplifying loop of inflammation and tissue damage (Kubiak et al

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These changes are associated with increased systemic inflammation markers, and some investigations have made correlations of microbial imbalance with faster disease progression (Obrenovich et al., 2020)

Zhernakova A, Kurilshikov A, Bonder MJ, Tigchelaar EF, Schirmer M, et al