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HMGB1 then activates danger-associated molecular pattern (DAMP) signaling, triggering microglial activation and proinflammatory cytokine release, thereby intensifying neuroinflammation and causing further disruption of the blood-brain barrier (205)

The short answer is, no one knows

When this process becomes disrupted, and the breakdown exceeds the ability to repair, symptoms, degeneration, and chronic conditions occur." Reasons for nerve damage include: Type 2 diabetes (peripheral neuropathy is a common diabetes complication) Chemotherapy Traumatic injury Surgery Alcohol abuse Hereditary diseases B vitamin deficiencies (Source 1, 2) B Vitamins and Nerve Repair In addition to addressing the root cause of nerve damage (like lowering blood sugar in diabetes), ensuring optimal B vitamin status is essential for healing

Findings from several randomized placebo-controlled trials suggest pirfenidone may slow disease progression (Azuma 2005