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This could be driven by increased ROS accumulation in cochlear cells, due for example to age-related decreases in mitochondrial membrane integrity (Shigenaga et al., 1994)

The HBP pathway produces UDP-GlcNAc, which acts as a substrate for N-glycosylation of M2-marked proteins, such as the N-glycosylation receptor CD206, as well as KLF4, CCL22, and IRF4, thereby promoting the polarization of M2 macrophages [96]

And the fact that blockade of serotonergic 5-HT2A receptors by atypical neuroleptics slows down the course of the disease

Glu170 is too far away from the active site to directly affect the interaction between HEDS and the cysteine thiolate