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For residents near Troy, MI , the answer might lie in something simpler: a Vitamin B12 deficiency

Wang, J.-J

In addition to this attack, which might be caused by homocysteinylation of the vascular wall proteins by homocysteine and/or its oxidized products (homocysteic acid, homocysteine sulfinic acid, and homocysteine thiolactone), in vitro and in vivo work suggests that reduced homocysteine can inhibit endothelial cell turn-over (Wang et al, 1997) and promote smooth muscle cell proliferation (Lubec et al, 1996b

112,113,114 The molecular mechanisms by which macrophage polarization is involved in the development of UC are shown in Fig

N Engl J Med 387(5):408420