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In addition to genetic susceptibility, increasing evidence suggests that environmental factorsincluding prenatal exposures, dietary patterns, gut microbial alterations, and metabolic stressorscontribute to ASD prevalence and phenotypic heterogeneity
L-carnitine also ameliorates oxidative stress by reducing ROS production (43, 47, 75), decreasing hepatic malondialdehyde (MDA) content (30, 59, 76), lowering 8-OHdG concentrations, and attenuating 4-hydroxynonenal (4-HNE) immunostaining intensity (45)
This case implies that the melanosis pigment-laden macrophages formed in the lamina propria of the colon pass to the regional lymph nodes and may explain the observation of similar pigment-laden macrophages in other sites
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