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The immune cells surrounding the nerve continuously release pro-inflammatory cytokines, which signal the brain to maintain a state of severe, flu-like sickness behavior, profound fatigue, and autonomic shutdown

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These cells secrete inhibitory cytokines such as TGF- and IL-10, and express immune checkpoint molecules such as PD-L1, jointly weakening the effector functions of cytotoxic CTLs and natural killer cells, thereby promoting tumor immune escape [88]