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The release of mitochondrial DNA (mtDNA) activates the cGAS-STING signaling axis, which then triggers macrophages in RA to secrete tumor necrosis factor- (TNF-), interleukin-1 (IL-1), and interleukin-6 (IL-6) [21]

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Such cross-compartmental activation links systemic metabolic stress to reproductive and vascular pathology, supporting a unifying hypothesis in which neutrophils serve as frontline effectors that translate metabolic imbalance into chronic inflammation