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This can result from chronic oxidative stress, heavy metal toxicity (especially iron overload), persistent infections, nutrient insufficiencies (sulfur amino acids, glycine, glutamate, selenium, B-vitamins), liver dysfunction, metabolic stress, and genetic polymorphisms in key enzymes like glutamate-cysteine ligase (GCL) or glutathione S-transferases (GSTs)

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The different stages of the efferocytosis process are not just a sequence of events, but a complex interplay that can interfere with the microenvironment by releasing soluble mediators (find-me signals) as a rich source of nutrients for phagocytes during the digestion process (digest-me), such as amino acids, nucleotides, lipids, and carbohydrates