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Enhanced Fat Metabolism and Energy Output Carnitines role is to shuttle fatty acids into mitochondria, where they are converted into usable energy

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Cytokine Profile Shift: As disease progresses, the adaptive immune response shifts from Th1 dominance to Th2 bias ( In vitro study indicate that -MSH significantly inhibits inflammation and pro-melanocortin POMC production in orbital fibroblasts associated with thyroid-related eye disease ( Hypoxic microenvironment induction effect: Rapidly proliferating fibroblasts and highly metabolically active inflammatory cells within the orbital cavity consume large amounts of oxygen, leading to the formation of localized hypoxic zones ( The core driving role of metabolic reprogramming: The metabolic state of macrophages progressively shifts from aerobic glycolysis during the active phase to a state dominated by oxidative phosphorylation and fatty acid oxidation ( 4.3 Quiescent phase: macrophage states dominated by pro-fibrotic functions lock the fibrosis process During the TED quiescent phase, the microenvironment is dominated by high levels of TGF-, PDGF, and specific extracellular matrix components

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