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Rebeca Esquivel-Zuniga Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA

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Alan D Rogol Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA

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psychosocial ones, can affect the timing and tempo of pubertal maturation. The pro-inflammatory cytokines, especially tumor necrosis factor α, interleukin 1β (IL), and IL-6 are prominent and may act directly at the growth plate ( 58 ). Immunomodulatory drugs

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