TNF and hypothyroidism: CXCL10 then binds to the CXCR3 receptor on Th1 cells (Ragusa et al., 2019), shifting the Th1/Th2 balance toward Th1 dominance; and (c) IFN-γ and TNF-α can also stimulate thyroid cells to synthesize and release IFN-γ-inducible chemokines into the circulation, which elicits thyroid destruction and hypothyroidism through pyroptosis (Ragusa et al., 2019; Weetman, 2021).