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Afrins own words, The general presenting motif of MCAS is chronic multisystem polymorbidity, generally of an inflammatory theme and with assorted elements waxing and waning over time, sometimes in synchronization with one another but more often cycling with different periods and amplitudes

Tucker M, Liao GY, Park JY, et al

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Importantly, it also involves the braingutimmunepain axis , a bidirectional network through which the central nervous system, gut, immune cells, and peripheral nerves communicate