High viral titers and cytokine/chemokine responses recruit more innate immune cells (monocytes, macrophages, neutrophils, DCs, and NK cells) and activate adaptive immune cells (CD4+ and CD8+ T cells) from peripheral tissues, which cause hyperactivation of the immune system and massive inflammation and lead to an inflammatory CS.11, 39, 43, 44, 45. Here, CD4 is linked to Cowden syndrome 1.