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There remains a need to systematically elucidate the immune pathogenesis of extrapulmonary complications in prospective cohort studies, identify specific early diagnostic biomarkers, evaluate the efficacy and safety of different immunomodulators in pediatric patients with specific mechanistic phenotypes, and establish long-term follow-up data to clarify the impact of various immune interventions on patient long-term outcomes

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Humoral and cellular immunity have been studied in patients with SD, though with conflicting results
