Possible contributing factors include bacterial or parasitic infections, immune system dysregulation and food intolerances or allergies, particularly to specific proteins
doi: 10.1093/qjmed/hcz157 76 LofgrenJ
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The genes it turns on are associated with collagen synthesis, wound healing, stem cell function, and DNA repair
Furthermore, ApoE4 + carriers display higher fertility rates in areas of high pathogen exposure (van Exel et al., 2017), suggesting an evolutionary adaptation against a variety of pathogens that would be selected for in our evolutionary past as ApoE4 is considered the original ancestral phenotype (Fullerton et al., 2000)