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For significant associations, we tested the potential explanatory effect of lifestyle and health-related variables by further including alcohol consumption, smoking status, physical activity, BMI and the number of self-reported current somatic diseases in the analytical models

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MSM+Vit C group (8 mg/Kg of MSM plus 5 mg/Kg of vitamin C, daily) and Control (no supplementation)

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These include costimulatory molecules such CD28 and ICOS that provide positive signals for T-cell growth and survival and coinhibitory molecules (PD1, CTLA4, LAG3, and VISTA) that are essential for suppressing T cell activation