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Only one study exists that has reported this important data at the time of writing this review, and this did not include the malate component

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Anti-TPO antibodies from healthy subjects did not block TPO activity or interfere with the blocking activity of anti-TPO antibodies from AITD patients (24), while anti-TPO antibodies from AITD patients can fix complement, destroy thyrocytes, and act as competitive inhibitors of enzymatic activity (25)

Elevated TCA levels also altered the innate (neutrophils and macrophages) and adaptive (Th1 and Th17 cells) immune responses in the mucosa, promoting the colonization of C